Options and limitations of long-term oral ciprofloxacin as antibacterial prophylaxis in allogeneic bone marrow transplant recipients.
The efficacy and safety of ciprofloxacin as long-term antibacterial prophylaxis after allogeneic bone marrow transplantation were assessed prospectively. Eighty-nine recipients of lymphocyte-depleted marrow grafts were each given ciprofloxacin orally, 500 mg twice daily. Fever developed in 71 out of 78 evaluable patients (91%) and was accompanied by positive blood cultures in 42 cases (59%). 'Viridans' streptococci, all but one with reduced in vitro susceptibility to ciprofloxacin, accounted for 35 episodes of bacteraemia. Thirty-three episodes occurred in patients given anthracyclines compared with only two episodes in other patients (chi 2 = 5.58: p less than 0.05). All bacteraemic fevers occurred within 11 days post-transplant. Gram-negative sepsis did not occur in any patient. Sixteen patients died but none due to a bacterial cause. Allergy to ciprofloxacin was registered in three out of 76 assessable cases (4%).
De Pauw
B E
BE
Department of Haematology, University Hospital St Radboud, Nijmegen, The Netherlands.
Donnelly
J P
JP
De Witte
T
T
Nováková
I R
IR
Schattenberg
A
A
D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000517:prevention & control*; D016026:Bone Marrow Transplantation / Q000379:methods*; D016009:Chi-Square Distribution; D002939:Ciprofloxacin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy; D006088:Gram-Negative Aerobic Bacteria / Q000187:drug effects*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013280:Stomatitis / Q000150:complications; D013291:Streptococcus / Q000302:isolation & purification
D002939:Ciprofloxacin