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Infection Prophylaxis in Acute Leukemia: A Comparison of Ciprofloxacin with Trimethoprim-Sulfamethoxazole and Colistin

ADRIAAN W. DEKKER, M.D.; MAJA ROZENBERG-ARSKA, M.D.; and JAN VERHOEF, M.D.
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▸Requests for reprints should be addressed to Adriaan W. Dekker, M.D.; Department of Hematology, University Hospital, P.O. Box 16250; 3500 CG Utrecht, the Netherlands.


Utrecht, the Netherlands


© 1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(1):7-12. doi:10.7326/0003-4819-106-1-7
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Fifty-six patients receiving remission induction treatment for acute leukemia were studied in a randomized trial comparing ciprofloxacin with trimethoprim-sulfamethoxazole plus Colistin for prevention of infections. Both groups received amphotericin B for antifungal prophylaxis. Six major infections occurred in 28 patients receiving ciprofloxacin, and 11 major infections occurred in 28 patients receiving trimethoprim-sulfamethoxazole plus Colistin. No infections caused by gram-negative bacilli were seen in the ciprofloxacin group (p < 0.02). Ciprofloxacin prevented colonization with resistant gram-negative bacilli, but 12 resistant colonizing strains were isolated from 10 patients receiving trimethoprim-sulfamethoxazole plus Colistin (p < 0.01). Ciprofloxacin was better tolerated: 23 of 28 patients were highly compliant to the drug, compared with 15 of 28 patients in the trimethoprim-sulfamethoxazole group (p < 0.05). These results suggest that ciprofloxacin is a promising drug for the prevention of infection in patients with granulocytopenia.

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