title: [Comparison of garenoxacin and levofloxacin for the prophylaxis of febrile neutropenia].
abstract: Placebo-controlled randomized trials have demonstrated that prophylactic levofloxacin (LVFX) significantly reduced the incidence of febrile neutropenia (FN) in patients receiving chemotherapy for advanced solid tumors. Garenoxacin (GRNX) has been reported to be more effective than LVFX against gram-positive bacteria especially Streptococcus pneumoniae. Against this background we conducted a study to compare the efficacy and safety of GRNX with that of LVFX for the prophylaxis of FN. We retrospectively analyzed 127 patients at high risk for FN who were administered GRNX or LVFX for the prophylaxis of FN that occurred during chemotherapy for advanced solid tumors. Our primary outcome of interest was the incidence of febrile episodes. Secondary outcomes included evidence of bacterial infection and infection focus when febrile episodes were observed; adverse drug reactions and mortality were also evaluated. Febrile episodes were observed in 2 patients administered GRNX and 7 patients administered LVFX (p=0.044). Definitive pathogenic bacteria and infection focus could not be identified in any patient with febrile episodes and all cases of fever resolved simultaneously with the recovery from neutropenia. We observed 4 cases of rashes and 3 cases of liver dysfunction in the GRNX group and 2 cases of rashes and 2 cases of liver dysfunctions were observed in the LVFX group(not statistically significant in both the groups). No severe adverse effects or deaths were associated with either of these drugs. These results suggest that GRNX is useful for the prophylaxis of FN.
authors.affiliation: Division of Integrated Oncology, Institute of Biomedical Research and Innovation.
authors.forename: Akito
authors.initials: A
authors.lastname: Hata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Masuda
authors.forename: Kenji
authors.initials: K
authors.lastname: Takashima
authors.forename: Jumpei
authors.initials: J
authors.lastname: Takeshita
authors.forename: Kosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Reiko
authors.initials: R
authors.lastname: Kaji
authors.forename: Shiro
authors.initials: S
authors.lastname: Fujita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ose
authors.forename: Naoto
authors.initials: N
authors.lastname: Kitajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D064147:Febrile Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D064704:Levofloxacin; C419689:garenoxacin