[Prophylaxis with ciprofloxacin in postchemotherapy neutropenia in acute myeloid leukemia].

BACKGROUND

Infection is the most frequent complication in patients with acute myeloid leukemia (AML) following chemotherapy. The new quinolones, among which ciprofloxacin may be found, seem to be effective in the prophylaxis of this complication.

METHODS

Fifty consecutive episodes of neutropenia were studied in patients with AML who received prophylaxis with ciprofloxacin and these were compared with a historic control group of another 50 consecutive episodes of neutropenia in AML patients who did not receive antibiotic prophylaxis. The difference with regard to the prevalence of infection and the characteristics of the same were studied.

RESULTS

Ciprofloxacin significantly decreased the number of febrile episodes following chemotherapy of induction or consolidation with respect to those who did not receive prophylaxis (68% versus 94%; p = 0.002). Likewise, the patients who received ciprofloxacin presented fewer bacteriologically documented infections (26% versus 50%; p = 0.023), bacteremias (10 versus 25, p = 0.03) and infections produced by Gram negative microorganisms (2 versus 13, p = 0.009). Ciprofloxacin led to disappearance of the infections produced by Pseudomonas aeruginosa. Delay in the development of infection was observed in patients who received ciprofloxacin (mean: 11 days, CI: 7-15 days) with respect to those who did not receive prophylaxis (mean: 6 days, CI: 4-6 days) (p = 0.0001).

CONCLUSIONS

Ciprofloxacin is an effective antibiotic in the prevention of infection in episodes of neutropenia after induction or consolidation chemotherapy in patients with acute myeloid leukemia. Not only does it decrease the number of febrile episodes, bacteriologically documented infections, bacteremias and infections produced by Gram negative microorganisms, but it also delays the appearance of the febrile episodes.