Eligible patients who consent to take part in CiproPAL and who are already enrolled in ALLTogether1 will be randomised (1:1) to the interventional arm or control arm of the trial.
Patients randomised to the interventional arm will receive prophylactic ciprofloxacin (10mg/kg twice a day, enteral or intravenously) from randomisation to the end of induction. Specifically, prophylactic ciprofloxacin should commence as soon as possible after randomisation (within the first 5-8 days of induction therapy) and continue until neutrophil recovery sufficient for the commencement of consolidation (ANC >0.5x109/L).
Patients randomised to the control arm will receive no additional treatment during induction. Such patients should receive the standard of care, as per local policy.
Any febrile episodes should be treated according tolocal guidelines. For patients in the interventionalarm (receiving prophylactic ciprofloxacin),ciprofloxacin prophylaxis should be stopped for theduration of any treatment with broad spectrumantibiotics, empirically or for a defined infection, andre-started afterwards. If antibiotic coverage isrationalised to treat a specific infection, for exampleteicoplanin for a Coagulase negativeStaphylococcus central line infection, thenciprofloxacin should be restarted. If there are anyuncertainties regarding restarting ciprofloxacinplease contact UCL CTC who will enquire with thetrial management group (TMG).