Fluoroquinolone prophylaxis in preventing BK polyomavirus infection after renal transplant: A systematic review and meta-analysis.
Previous studies regarding the prevention of BK viremia following renal transplantation with fluoroquinolone have yielded conflicting results. The purpose of this systematic review was to examine the evidence regarding the efficacy of fluoroquinolone in preventing BK polyomavirus infection following renal transplantation. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for research articles published prior to January 2015 using keywords such as "fluoroquinolone," "BK viremia," and "renal transplantation." We extracted all types of study published in English. The primary outcome was BK viremia and viruria at 1 year post-transplantation. Secondary outcomes were BK virus-associated nephropathy (BKVN), graft failure, and fluoroquinolone-resistant infection. We identified eight trials, including a total of 1477 participants with a mean duration of fluoroquinolone prophylaxis of >1 month. At 1 year, fluoroquinolone prophylaxis was not associated with a decreased incidence of BK viremia [risk ratio (RR), 0.84; 95% confidence interval (95% CI), 0.58-1.20). No significant differences in BKVN (RR, 0.88; 95% CI, 0.37-2.11), risk of graft failure due to BKVN (RR, 0.68; 95% CI, 0.29-1.59), or fluoroquinolone-resistant infection (RR, 1.08; 95% CI, 0.64-1.83) were observed between the fluoroquinolone prophylaxis and control groups. The results of this study suggest that fluoroquinolone is ineffective in preventing BK polyomavirus infection following renal transplantation.
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Tu-Run
TR
Song
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Zheng-Sheng
ZS
Rao
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Yang
Y
Qiu
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Jin-Peng
JP
Liu
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Zhong-Li
ZL
Huang
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China.
Xian-Ding
XD
Wang
Department of Urology, Urology Institute and Organ Transplantation Center, West China Hospital, Sichuan University, Sichuan, China. Electronic address: Kidney5@163.com.
Tao
T
Lin
D001739:BK Virus / Q000502:physiology*; D024841:Fluoroquinolones / Q000627:therapeutic use*; D018740:Genetic Heterogeneity; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D027601:Polyomavirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D017594:Publication Bias; D016896:Treatment Outcome
D024841:Fluoroquinolones
BK polyomavirus; Fluoroquinolones; Kidney transplantation