Effectiveness and safety of the pre-prescription of garenoxacin in comparison to moxifloxacin for low-risk febrile neutropenia in breast cancer patients undergoing adjuvant and neoadjuvant chemotherapy

  • Masaya Takahashi
  • Katsuyuki Takahashi
  • Kazuki Ogawa
  • Tsutomu Takashima
  • Yuka Asano
  • Shinichiro Kashiwagi
  • Satoru Noda
  • Naoyoshi Onoda
  • Masaichi Ohira
  • Katsuya Nagayama
Original Article



The purpose of this study was to compare the efficacy of the pre-prescription of garenoxacin mesylate hydrate (GRNX) with that of moxifloxacin hydrochloride (MFLX) in the management of breast cancer patients with low-risk febrile neutropenia.


Data from female patients who had been instructed to take previously prescribed oral GRNX or MFLX for 3 days during adjuvant and neoadjuvant chemotherapy if their body temperature exceeded 38 °C were analyzed. This study compared the effectiveness between these fluoroquinolones using a propensity score matching analysis.


The 330 patients received 1192 administrations of chemotherapy between May 2007 and April 2014 and 136 (41.2%) patients had a total of 212 (17.8%) febrile episodes. The frequencies of febrile episodes were 19.5% (113/579) and 16.2% (99/613) in the GRNX and MFLX groups, respectively. After propensity score matching, 384 episodes were matched in each group. Febrile events occurred in 80 and 56 cases in the GRNX and MFLX groups, respectively. Treatment success was identified in 80.0% (64/80) of cases in the GRNX group and 64.3% (36/56) of cases in the MFLX group (P = 0.0494). Additionally, the therapeutic use of granulocyte-colony stimulating factor was 6.3% (5/80) of cases in the GRNX group and 17.9% (10/56) of cases in the MFLX group (P = 0.0498). There were few differences in the frequency of adverse effects between the two groups.


These results indicate that the pre-prescription of GRNX may be a more effective option for the management of low-risk febrile neutropenia during adjuvant and neoadjuvant chemotherapy for breast cancer.


Pre-prescription Garenoxacin Moxifloxacin Low-risk febrile neutropenia Breast cancer Adjuvant chemotherapy 

Abbreviations in Figures and Tables


garenoxacin mesylate hydrate


moxifloxacin hydrochloride


body surface area


body mass index


5-fluorouracil, epirubicin, cyclophosphamide


adriamycin, cyclophosphamide


docetaxel, cyclophosphamide


aspartate aminotransferase


alanine aminotransferase


granulocyte-colony stimulating factor


febrile neutropenia



We would like to thank Editage ( for English language editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants and/or animals

This study was approved by the Human Subjects Review Committee at Osaka City University (No. 3725).

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Masaya Takahashi
    • 1
  • Katsuyuki Takahashi
    • 1
  • Kazuki Ogawa
    • 1
  • Tsutomu Takashima
    • 2
  • Yuka Asano
    • 2
  • Shinichiro Kashiwagi
    • 2
  • Satoru Noda
    • 2
  • Naoyoshi Onoda
    • 2
  • Masaichi Ohira
    • 2
  • Katsuya Nagayama
    • 1
  1. 1.Department of PharmacyOsaka City University HospitalOsakaJapan
  2. 2.Department of Breast and Endocrine SurgeryOsaka City University Graduate School of MedicineOsakaJapan

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