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接受高剂量治疗和自体造血干细胞移植患者的口服环丙沙星预防治疗

Oral Ciprofloxacin Prophylaxis in Patients Undergoing High DoseTherapy and Autologous Hematopoietic Stem Cell Transplantation.

作者信息

Tabarraee Mahdi, Tavakoli-Ardakani Maria, Mehdizadeh Mahshid, Ghadiani Mojtaba, Rezvani Hamid, Hajifathali Abbas, Khamsi Samiyeh

机构信息

Hematology and oncology center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Pharm Res. 2016 Winter;15(Suppl):159-163.

Abstract

Antibiotic prophylaxis is usually used in allogeneic stem cell transplantation, but its use in Autologous Stem Cell Transplantation (ASCT) is controversial. We evaluated the efficacy of ciprofloxacin prophylaxis in ASCT. To identify the efficacy of ciprofloxacin on the incidence of neutropenic fever and its complications, 72 patients that had been admitted to Taleghani Hospital for ASCT between 2010 and 2012 were evaluated in our study. Oral ciprofloxacin 500 mg every 12 h was administered to 30 patients on the same day of high dose chemotherapy until the first febrile episode or until the recovery of neutropenia and the results were analyzed and compared with the historical control group 42 other transplanted patients who had not previously received ciprofloxacin. The incidence of neutropenic fever was 80% with no difference between the two groups. But in ciprofloxacin group, duration of fever (1.7 days VS 3.5 days P=0.017), hospitalization due to stem cell transfusion (18.2 days VS 12.2 days p=0.03), incidence of bacteremia 3.3 % VS 33.3%, p=0.002) and platelet recovery (13.9 VS 17.7 days= 0.035) and platelet transfusions (P=0.04) were significantly lower than the control group no side effects and no delay in. Based on this study oral ciprofloxacin prophylaxis is rational, efficacious and economic in ASCT.

摘要

抗生素预防通常用于异基因干细胞移植,但在自体干细胞移植(ASCT)中的应用存在争议。我们评估了环丙沙星在ASCT中的预防效果。为确定环丙沙星对中性粒细胞减少性发热及其并发症发生率的影响,我们对2010年至2012年间入住塔莱加尼医院接受ASCT的72例患者进行了研究。30例患者在大剂量化疗当天开始每12小时口服500毫克环丙沙星,直至首次发热发作或中性粒细胞减少症恢复,然后分析结果并与42例未接受过环丙沙星治疗的其他移植患者的历史对照组进行比较。中性粒细胞减少性发热的发生率为80%,两组之间无差异。但在环丙沙星组中,发热持续时间(1.7天对3.5天,P=0.017)、因干细胞输注住院时间(18.2天对12.2天,p=0.03)、菌血症发生率(3.3%对33.3%,p=0.002)以及血小板恢复时间(13.9天对17.7天=0.035)和血小板输注量(P=0.04)均显著低于对照组,且无副作用且无延迟。基于这项研究,口服环丙沙星预防在ASCT中是合理、有效且经济的。

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