title: Moxifloxacin is more effective than tosufloxacin in reducing chemotherapy-induced febrile neutropenia in patients with hematological malignancies.
abstract: Recent studies have shown the prophylactic efficacy of fluoroquinolones against infections in patients with chemotherapy-induced neutropenia. However, little is known about the differences between fluoroquinolones, and there are some concerns about the emergence of resistant bacteria. In this retrospective study, we compared the prophylactic efficacy of moxifloxacin (MFLX) and tosufloxacin (TFLX) for chemotherapy-induced febrile neutropenia. The cumulative incidences of febrile neutropenia were 74.7% (59 of 79) in the MFLX group and 81.1% (219 of 270) in the TFLX group (log-rank test p = 0.044). Subgroup analysis revealed a more prominent prophylactic advantage of MFLX in patients with acute myeloid leukemia (AML) or long duration of neutropenia (p = 0.013 and 0.008, respectively). There were no significant differences in the incidences of adverse events and fluoroquinolone resistant bacteria in both groups. This study indicates that prophylaxis with MFLX is more beneficial to reduce febrile neutropenia episodes than TFLX, especially in patients with high-risk disease.
authors.affiliation: Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Shinohara
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshiki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Masamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Hangaishi
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Nannya
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000209:etiology*; D024841:Fluoroquinolones / Q000627:therapeutic use*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D009287:Naphthyridines / Q000627:therapeutic use*; D009503:Neutropenia / Q000139:chemically induced* / Q000401:mortality / Q000517:prevention & control*; D011804:Quinolines / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D009287:Naphthyridines; D011804:Quinolines; C055185:tosufloxacin; D000077266:Moxifloxacin