TITLE:
Evaluation of Prophylaxis with Norfloxacin and Ceftriaxone versus Ciprofloxacin during the Period of Neutropenia after Haematopoietic Stem Cell Transplantation: Retrospective Analysis of Two Sequencial Cohorts
AUTHORS:
Valeria Paes Lima Fernandes, Paola Cappellano, Maria Daniela DiDea Bergamasco, Janaina Midori Goto, Jose Salvador Rodrigues de Oliveira, Carlos Alberto Pires Pereira
KEYWORDS:
Febrile Neutropenia, Prophylaxis, Haematopoietic Stem Cell Transplantation, Ciprofloxacin, Ceftriaxone
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.4 No.2,
June
9,
2014
ABSTRACT:
Background: The aim of this study was to
evaluate the occurrence of febrile neutropenia (FN) during aplasia after
haematopoietic stem cell transplantation (HSCT) in patients who received anti-bacterial
prophylaxis with norfloxacin/ceftriaxone or ciprofloxacin, between September
2006 and May 2009. Methods: We retrospectively examined all patients undergoing
HSCT at S?o Paulo Hospital during the study period. Results: Of the 107 studied
patients, 71 (66.3%) were included in the analysis. The exclusion criteria were
as follows: occurrence of fever or infection before the transplantation (17),
prophylactic use of norfloxacin (6), fever of probable non-infectious aetiology
(2), and absence of prophylaxis during the aplasia period (11). Thirty-eight
patients received norfloxacin and ceftriaxone as prophylaxis (Group I) and 33
received ciprofloxacin (Group II). The groups were comparable with respect to
age, underlying diseases, comorbidities, and status of the underlying disease.
Patients in Group II used antibiotics in a significantly higher frequency than
those in Group I (66.7% vs 33.8%, p = 0.017), for 30 days before
transplantation. The number of previous hospitalisations, length of
hospitalisation until transplantation, type of transplant, progenitor cells
used, number of CD34 cells infused, type of conditioning, and graft-versus-host
disease prophylaxis were similar in both groups. After the transplantation,
28.9% and 39.4% of the patients in Groups I and II, respectively, presented
Grade III and IV mucositis (p = 0.448). Neutropenia of