Infection prophylaxis in acute leukemia: a comparison of ciprofloxacin with trimethoprim-sulfamethoxazole and colistin.
Fifty-six patients receiving remission induction treatment for acute leukemia were studied in a randomized trial comparing ciprofloxacin with trimethoprim-sulfamethoxazole plus colistin for prevention of infections. Both groups received amphotericin B for antifungal prophylaxis. Six major infections occurred in 28 patients receiving ciprofloxacin, and 11 major infections occurred in 28 patients receiving trimethoprim-sulfamethoxazole plus colistin. No infections caused by gram-negative bacilli were seen in the ciprofloxacin group (p less than 0.02). Ciprofloxacin prevented colonization with resistant gram-negative bacilli, but 12 resistant colonizing strains were isolated from 10 patients receiving trimethoprim-sulfamethoxazole plus colistin (p less than 0.01). Ciprofloxacin was better tolerated: 23 of 28 patients were highly compliant to the drug, compared with 15 of 28 patients in the trimethoprim-sulfamethoxazole group (p less than 0.05). These results suggest that ciprofloxacin is a promising drug for the prevention of infection in patients with granulocytopenia.
Dekker
A W
AW
Rozenberg-Arska
M
M
Verhoef
J
J
D000208:Acute Disease; D000380:Agranulocytosis / Q000150:complications; D001424:Bacterial Infections / Q000517:prevention & control*; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use*; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D006801:Humans; D007938:Leukemia / Q000150:complications*; D007945:Leukemia, Lymphoid / Q000150:complications*; D010349:Patient Compliance; D011897:Random Allocation; D013419:Sulfamethizole / Q000009:adverse effects / Q000627:therapeutic use*; D013432:Sulfathiazoles / Q000627:therapeutic use*; D014295:Trimethoprim / Q000009:adverse effects / Q000627:therapeutic use*; D000096926:Benzenesulfonamides
D002939:Ciprofloxacin; D003091:Colistin; D004338:Drug Combinations; D013419:Sulfamethizole; D013432:Sulfathiazoles; D014295:Trimethoprim; C029078:trimethoprim sulfamethizole; D000096926:Benzenesulfonamides