Skip to main content

Advertisement

SpringerLink
Log in

Comparison of antibiotic prophylaxis with cotrimoxazole/colistin (COT/COL) versus ciprofloxacin (CIP) in patients with acute myeloid leukemia

  • Original Paper
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Recent meta-analyses showed that antibiotic prophylaxis in patients with neutropenia after chemotherapy reduced the incidence of fever and mortality rate. Fluoroquinolones appear to be most effective and well tolerated. Thus, in April 2008, we changed our antibiotic prophylaxis regimen from cotrimoxazole/colistin (COT/COL) to the fluoroquinolone ciprofloxacin (CIP) in patients with acute myeloid leukemia (AML). The aim of this retrospective study was to compare efficacy and development of bacterial resistance with two different prophylaxis regimens over a time period of more than 4 years.

Methods

Induction chemotherapy courses given for AML during the antibiotic prophylaxis period with COT/COL (01/2006-04/2008) and CIP (04/2008-06/2010) were retrospectively analyzed with a standard questionnaire.

Results

Eighty-five courses in the COT/COL group and 105 in the CIP group were analyzed. The incidence of fever was not significantly different (COT/COL 80 % vs CIP 77 %; p = 0.724). Also, the rate of microbiologically documented infections was nearly the same (29 vs 26 %; p = 0.625). In addition, there was no significant difference in the incidence of clinically documented infections (11 vs 19 %; p = 0.155) or in the rates of detected gram-positive and gram-negative bacteria. Of note, there was no increase in resistance rates or cases with Clostridium difficile-associated diarrhea in the CIP group.

Conclusion

The antibiotic prophylaxis with CIP compared to COT/COL in AML was similarly effective with no increase in bacterial resistance. COT/COL may have the advantages of providing additional prophylaxis against Pneumocystis jirovecii pneumonia and leaving fluoroquinolones as an additional option for treatment of febrile neutropenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cullen M, Steven N, Billingham L, Gaunt C, Hastings M, Simmonds P, Stuart N, Rea D, Bower M, Fernando I, Huddart R, Gollins S, Stanley A (2005) Simple investigation in neutropenic individuals of the frequency of infection after chemotherapy +/- antibiotic in a number of tumours (SIGNIFICANT) Trial Group. Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med 353:988–998

    Article  CAS  PubMed  Google Scholar 

  2. Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, Allione B, D'Antonio D, Buelli M, Nosari AM, Cilloni D, Zuffa E, Cantaffa R, Specchia G, Amadori S, Fabbiano F, Deliliers GL, Lauria F, Foà R, for the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) Infection Program (2005) Levoflocaxin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med 353:977–987

    Article  CAS  PubMed  Google Scholar 

  3. Gafter-Gvili A, Fraser A, Paul M, Vidal L, Lawrie TA, van de Wetering MD, Kremer LCM, Leibovici L (2012) Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev 1, CD004386. doi:10.1002/14651858.CD004386.pub3

    PubMed Central  PubMed  Google Scholar 

  4. Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, Kuderer NM, Langston AA, Marr KA, Rolston KV, Ramsey SD (2013) Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 31:794–810

    Article  PubMed  Google Scholar 

  5. Neumann S, Krause SW, Maschmeyer G, Schiel X, von Lilienfeld-Toal M, Infectious Diseases Working Party (AGIHO); German Society of Hematology and Oncology (DGHO) (2013) Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematological malignancies and solid tumors. Ann Hematol 92:433–442

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Schlenk RF, Fröhling S, Hartmann F, Fischer JT, Glasmacher A, del Valle F, Grimminger W, Götze K, Waterhouse C, Schoch R, Pralle H, Mergenthaler HG, Hensel M, Koller E, Kirchen H, Preiss J, Salwender H, Biedermann HG, Kremers S, Griesinger F, Benner A, Addamo B, Döhner K, Haas R, Döhner H, AML Study Group Ulm (2004) Phase III study of all-trans retinoic acid in previously untreated patients 61 years or older with acute myeloid leukemia. Leukemia 18:1798–1803

    Article  CAS  PubMed  Google Scholar 

  7. von Lilienfeld-Toal M, Hahn-Ast C, Kirchner H, Flieger D, Dölken G (2007) A randomized comparison of immediate versus delayed application of G-CSF in induction therapy for patients with acute myeloid leukemia unfit for intensive chemotherapy. Haematologica 92:1719–1720

    Article  Google Scholar 

  8. Clinical and Laboratory Standards Institute (2007) Performance standards for antimicrobial susceptibility testing; seventeenth informational supplement. CLSI document M100-S17. ISBN 1-56238-625-5

  9. Arning M, Wolf HH, Aul C, Heyll A, Scharf RE, Scheider W (1990) Infection prophylaxis in neutropenic patients with acute leukemia-a randomized, comparative study with ofloxacin, ciprofloxacin and co-trimoxazole/colistin. J Antimicrob Chemother 26:137–142

    Article  PubMed  Google Scholar 

  10. Donelly JP, Maschmeyer G, Daenen S (1992) Selective oral antimicrobial prophylaxis for the prevention of infection in acute leukaemia-ciprofloxacin versus co-trimoxazole plus colistin. The EORTC-Gnotobiotic Project Group. Eur J Cancer 28:873–878

    Article  Google Scholar 

  11. Engels EA, Lau J, Barza M (1998) Efficacy of quinolone prophylaxis in neutropenic cancer patients: a meta-analysis. J Clin Oncol 16:1179–1187

    CAS  PubMed  Google Scholar 

  12. Oppenheim BA (1998) The changing pattern of infection in neutropenic patients. J Antimicrob Chemother 41(Suppl D):7–11

    Article  CAS  PubMed  Google Scholar 

  13. Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB (2003) Current trends in the epidemiology of nosocomial bloodstream infections in patients with haematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 36:1103–1110

    Article  PubMed  Google Scholar 

  14. Polk RE, Jaohnson CK, McClish D, Wenzel RP, Edmond MB (2004) Predicting hospital rates of fluoroquinolone-resistant Pseudomonas aeruginosa from fluoroquinolone use in US hospitals and their surrounding communities. Clin Infect Dis 39:497–503

    Article  PubMed  Google Scholar 

  15. Cattaneo C, Quaresmini G, Casari S, Capucci MA, Micheletti M, Borlenghi E, Signorini L, Re A, Carosi G, Rossi G (2008) Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution. J Antimicrob Chemother 61:721–728

    Article  CAS  PubMed  Google Scholar 

  16. Bhusal Y, Mihu CN, Tarrand JJ, Rolston KV (2011) Incidence of fluoroquinolone-resistant and extended-spectrum ß-lactamase-producing Escherichia coli at a comprehensive cancer center in the United States. Chemotherapy 57:335–338

    Article  CAS  PubMed  Google Scholar 

  17. Pépin J, Saheb N, Coulombe MA, Alary ME, Corriveau MP, Authier S, Leblanc M, Rivard G, Bettez M, Primeau V, Nguyen M, Jacob CE, Lanthier L (2005) Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 41:1254–1260

    Article  PubMed  Google Scholar 

  18. Graffunder EM, Venezia RA (2002) Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother 49:999–1005

    Article  CAS  PubMed  Google Scholar 

  19. Simondsen KA, Reed MP, Mably MS, Zhang Y, Longo WL (2012) Retrospective analysis of fluoroquinolone prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation. J Oncol Pharm Pract 0:1–7

    Google Scholar 

  20. Chong Y, Yakushiji H, Ito Y, Kamimura T (2011) Clinical impact of fluoroquinolone prophylaxis in neutropenic patients with haematological malignancies. Int J Infect Dis 15:e277–e281

    Article  CAS  PubMed  Google Scholar 

  21. Heimpel H, Raghavachar A (1987) Hematological side effects of co-trimoxazole. Infection 5:248–252

    Article  Google Scholar 

Download references

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Medizinische Klinik III, Hämatologie/Onkologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    Karin Mayer, Corinna Hahn-Ast, Sara Mückter, Andrea Schmitz, Simon Krause, Linda Felder, Peter Brossart & Marie von Lilienfeld-Toal

  2. Institut für Medizinische Mikrobiologie, Immunologie und Parasitologie (IMMIP), Universitätsklinikum Bonn, Bonn, Germany

    Isabelle Bekeredjian-Ding & Ernst Molitor

  3. Klinik für Innere Medizin II, Abteilung für Hämatologie und Onkologie, Universitätsklinikum Jena, Jena, Germany

    Marie von Lilienfeld-Toal

  4. Leibniz-Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll Institut, Jena, Germany

    Marie von Lilienfeld-Toal

  5. Center for Sepsis Control and Care (CSCC), Universitätsklinikum Jena, Jena, Germany

    Marie von Lilienfeld-Toal

Authors
  1. Karin Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corinna Hahn-Ast
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sara Mückter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrea Schmitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Simon Krause
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Linda Felder
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Isabelle Bekeredjian-Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ernst Molitor
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Peter Brossart
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Marie von Lilienfeld-Toal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karin Mayer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mayer, K., Hahn-Ast, C., Mückter, S. et al. Comparison of antibiotic prophylaxis with cotrimoxazole/colistin (COT/COL) versus ciprofloxacin (CIP) in patients with acute myeloid leukemia. Support Care Cancer 23, 1321–1329 (2015). https://doi.org/10.1007/s00520-015-2621-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-2621-0

Keywords

Search

Navigation