A 3-month course of ciprofloxacin does not prevent BK virus replication in heavily immunosuppressed kidney-transplant patients.
In vitro and retrospective studies of kidney-transplant patients have shown that quinolones can efficiently prevent BK virus (BKV) replication. However, in a prospective study, a 3 month-course of levofloxacin did not decrease the rate of BK viruria in kidney-transplant patients treated with standard immunosuppression.



The aim of this study was to assess the effect of a 3-month course of ciprofloxacin prophylaxis on BKV replication in kidney-transplant patients that had received heavy immunosuppression (plasma exchange or immunoadsorption and rituximab) to achieve desensitization before undergoing HLA- and/or ABO-incompatible (ABOi) transplantation.



Twenty-nine patients were given ciprofloxacin (500mg/d) for 3 months, starting immediately after transplantation. The results were compared with results from a previous study where patients had received a similar immunosuppression regimen without ciprofloxacin prophylaxis (n=43). Around 60% of patients had undergone a retransplantation. After transplantation, all patients were given induction therapy, tacrolimus, mycophenolic acid and steroids. BK viruria and viremia were monitored at months 1, 3, 6 and 12 post-transplantation.



The rates of BK viruria, BK viremia, and BKV-associated nephropathy did not differ between patients who were given or not given ciprofloxacin prophylaxis. These rates were also identical when patients received quinolones at any time within the first year after transplantation compared to those that had not. The rate of bacterial infection was also similar in patients who had or had not received ciprofloxacin.



The use of quinolones seemed to not have any beneficial effect in preventing BKV replication in kidney-transplant patients receiving heavy immunosuppression.
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
Marine
M
Lebreton
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
Laure
L
Esposito
Laboratory of Virology, CHU Purpan, Toulouse, France.
Catherine
C
Mengelle
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
Arnaud
A
Del Bello
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Université Paul Sabatier, Toulouse, France.
Antoine
A
Delarche
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Université Paul Sabatier, Toulouse, France.
Gaëlle
G
Dörr
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Université Paul Sabatier, Toulouse, France.
David
D
Milongo
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.
Olivier
O
Marion
Laboratory of Virology, CHU Purpan, Toulouse, France; Université Paul Sabatier, Toulouse, France; INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.
Jacques
J
Izopet
Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; Université Paul Sabatier, Toulouse, France; INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France. Electronic address: kamar.n@chu-toulouse.fr.
Nassim
N
Kamar
D000998:Antiviral Agents / Q000008:administration & dosage*; D001739:BK Virus / Q000254:growth & development* / Q000502:physiology; D018890:Chemoprevention / Q000379:methods*; D002939:Ciprofloxacin / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D066027:Transplant Recipients; D016896:Treatment Outcome; D014779:Virus Replication
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D002939:Ciprofloxacin
Apheresis; BK virus; Kidney transplantation; Polyclonal antibodies; Quinolones; Rituximab