Antibacterial prophylaxis of febrile neutropenia is not effective in the pre-engraftment period in pediatric allogeneic hematopoietic stem cell transplantation.

: the recently published guideline by Lehrnbecher et al [1] on antibacterial prophylaxis for prevention of febrile neutropenia in cancer children gives a weak recommendation with a moderate quality evidence not to administer systemic antibacterial prophylaxis for children undergoing allogeneic hematopoietic stem cell transplantation (HSCT). This recommendation was based mainly on a single randomized clinical trial [2], showing no effectiveness of levofloxacin compared to no prophylaxis (effectiveness 11.0% vs 17.3%; risk difference: 6.3%; p =0.06).