Journal Article

Ciprofloxacin Decreased Polyoma BK Virus Load in Patients Who Underwent Allogeneic Hematopoietic Stem Cell Transplantation

Anskar Y. H. Leung, Maggie T. L. Chan, Kwok-Yung Yuen, Vincent C. C. Cheng, Kwok-Hung Chan, Chris L. P. Wong, Raymond Liang, Albert K. W. Lie and Yok-Lam Kwong

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 4, pages 528-537
Published in print February 2005 | ISSN: 1058-4838
Published online February 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/427291
Ciprofloxacin Decreased Polyoma BK Virus Load in Patients Who Underwent Allogeneic Hematopoietic Stem Cell Transplantation

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Background. Polyoma BK virus (BKV) is associated with hemorrhagic cystitis during hematopoietic stem cell transplantation (HSCT). The objective of this study was to test whether standard-dose ciprofloxacin might suppress reactivation of BKV infection during HSCT.

Methods. Sixty-eight patients received ciprofloxacin or a cephalosporin as antibiotic prophylaxis after undergoing allogeneic HSCT. Urine samples were collected weekly from day 7 before HSCT to day 50 after HSCT. Laboratory investigations included quantification of BKV load and urinary ciprofloxacin levels and in vitro drug sensitivity of BKV.

Results. Twenty-two patients received ciprofloxacin, 21 received cephalosporins, 12 received concomitant corticosteroids and antibiotics (9 received ciprofloxacin, and 3 received cephalosporins), and 13 received interrupted ciprofloxacin therapy. Ciprofloxacin recipients developed a significantly lower peak BKV load, compared with cephalosporin recipients (median, 3 × 105 copies/mL vs. 2.6 × 109 copies/mL; P = .021), irrespective of concomitant receipt of corticosteroid therapy. Fewer ciprofloxacin recipients than cephalosporin recipients (P = .013) developed BKV viruria with a ⩾3-log increase in BKV load during HSCT, which was associated with significantly more cases of hemorrhagic cystitis (8 of 29 patients with a peak increase of ⩾3 log vs. 0 of 39 patients without a peak increase of this level; P < .001). Ciprofloxacin recipients excreted ciprofloxacin in urine at a mean 24-h rate of 71.7 µg/mL (range, 23.0–152.9 µg/mL), which was comparable with the in vitro inhibitory concentration of 125–250 µg/mL of ciprofloxacin found for 3 of 7 BKV isolates.

Conclusions. Ciprofloxacin decreased urinary BKV reactivation after HSCT.

Journal Article.  3446 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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