Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Leuk Lymphoma. 2013 Apr;54(4):794-8. doi: 10.3109/10428194.2012.725848. Epub 2013 Jan 2.
Recent studies have shown the prophylactic efficacy of fluoroquinolones against infections in patients with chemotherapy-induced neutropenia. However, little is known about the differences between fluoroquinolones, and there are some concerns about the emergence of resistant bacteria. In this retrospective study, we compared the prophylactic efficacy of moxifloxacin (MFLX) and tosufloxacin (TFLX) for chemotherapy-induced febrile neutropenia. The cumulative incidences of febrile neutropenia were 74.7% (59 of 79) in the MFLX group and 81.1% (219 of 270) in the TFLX group (log-rank test p = 0.044). Subgroup analysis revealed a more prominent prophylactic advantage of MFLX in patients with acute myeloid leukemia (AML) or long duration of neutropenia (p = 0.013 and 0.008, respectively). There were no significant differences in the incidences of adverse events and fluoroquinolone resistant bacteria in both groups. This study indicates that prophylaxis with MFLX is more beneficial to reduce febrile neutropenia episodes than TFLX, especially in patients with high-risk disease.
最近的研究表明，氟喹诺酮类药物对化疗引起的中性粒细胞减少症患者的感染具有预防作用。然而，人们对氟喹诺酮类药物之间的差异知之甚少，并且人们对耐药菌的出现存在一些担忧。在这项回顾性研究中，我们比较了莫西沙星（MFLX）和托氟沙星（TFLX）预防化疗引起的发热性中性粒细胞减少症的疗效。MFLX 组发热性中性粒细胞减少症的累积发生率为 74.7%（59/79），TFLX 组为 81.1%（219/270）（对数秩检验，p=0.044）。亚组分析显示，MFLX 在急性髓细胞白血病（AML）或中性粒细胞减少时间较长的患者中具有更显著的预防优势（分别为 p=0.013 和 0.008）。两组不良事件和氟喹诺酮耐药菌的发生率无显著差异。本研究表明，与 TFLX 相比，MFLX 预防可更有效地减少发热性中性粒细胞减少症的发生，尤其是在高危疾病患者中。
