Fluoroquinolones, antimicrobial resistance and neutropenic cancer patients
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
PURPOSE OF REVIEW: Fluoroquinolone antibiotics are widely used in our communities and healthcare facilities. This review focuses upon the relationship between fluoroquinolone use and the rising prevalence in neutropenic cancer patients of multidrug resistant pathogens including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, Clostridium difficile, and aerobic Gram-negative bacilli. RECENT FINDINGS: Fluoroquinolones such as ciprofloxacin or levofloxacin are efficacious for the prevention and treatment of neutropenic fever syndromes, including infections due to aerobic Gram-negative bacilli. Recent clinical practice guidelines recommend their prophylactic use in acute leukaemia patients receiving intensive remission-induction, postremission consolidation, or salvage induction therapy, and haematopoietic stem cell transplant recipients during pre-engraftment when the duration of profound neutropenia (absolute neutrophil count <0.1 × 10(9)/l) is at least 7 days. These same agents combined with amoxicillin/clavulanate are recommended for oral outpatient empirical antibacterial treatment of febrile neutropenic patients at low risk for medical complications. Fluoroquinolone-resistant Enterobacteriaceae is linked to community fluoroquinolone consumption. Prophylaxis efficacy is reduced when the prevalence of fluoroquinolone Gram-negative bacillary resistance exceeds 20%. Widespread use encourages the transmissibility of multiclass antimicrobial resistance genes among Gram-negative bacilli. Fluoroquinolone-driven colonization with MRSA enhances the risk of subsequent infection, the use of vancomycin, and risk of colonization by vancomycin-resistant Enterococcus spp. The relative roles of widespread fluoroquinolone use and ineffective infection prevention and control practices in encouraging the spread of virulent C. difficile-associated diarrhoea in healthcare facilities remain controversial. SUMMARY: Widespread use of antibacterial agents of one class can encourage multiclass drug resistance, which reduces prophylaxis and treatment efficacy in neutropenic cancer patients.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it