Comparison of garenoxacin with levofloxacin as antimicrobial prophylaxis in acute myeloid leukemia.
Comparison of garenoxacin with levofloxacin as antimicrobial prophylaxis in acute myeloid leukemia.
复制标题
加雷诺沙星与左氧氟沙星作为急性髓系白血病预防性抗菌药物的比较。
DOI：
10.1093/jjco/hyv071
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发表时间：
2015
期刊：
影响因子：
2.4
通讯作者：
Kurokawa M.
中科院分区：
文献类型：
--
作者：
Uni M;Yoshimi A;Yamazaki S;Taoka K;Shinohara A;Nannya Y;Nakamura F;Kurokawa M.
目的广泛应用左氧氟沙星作为预防高危化疗所致中性粒细胞减少症的抗菌药物。加诺沙星是日本开发的一种氟喹诺酮类药物，对革兰氏阳性细菌的体外抗菌活性比左氧氟沙星强。方法回顾性分析高危急性髓系白血病患者化疗期间给予加兰诺沙星（n= 36）或左氧氟沙星（n= 120）的临床资料。我们比较了这些氟喹诺酮类药物的感染概况。结果加诺沙星组和左氧氟沙星组发热事件发生率分别为31例（86%）和93例（78%）（P= 0.35）。加兰诺沙星组革兰氏阳性菌血流感染1例（3%），左氧氟沙星组25例（21%）（P< 0.01）。左氧氟沙星组和加诺沙星组分别有5例（4%）和8例（22%）血液感染革兰阴性菌（P< 0.01）。结论不同氟喹诺酮类药物的抗菌谱可能存在较大差异。虽然由于样本量较小和回顾性的性质，存在一些偏差，但当我们给血液病患者使用预防性氟喹诺酮时，我们应该考虑到这些差异。
ObjectiveLevofloxacin is widely used as antimicrobial prophylaxis against high-risk chemotherapy-induced neutropenia. Garenoxacin, a fluoroquinolone developed in Japan, shows a strongerin vitroantimicrobial activity against Gram-positive bacteria than levofloxacin.MethodsWe retrospectively analyzed high-risk patients with acute myeloid leukemia who were administered garenoxacin (n= 36) or levofloxacin (n= 120) during chemotherapy. We compared the profiles of infections between these fluoroquinolones.ResultsFebrile events occurred in 31 (86%) and 93 (78%) cases in the garenoxacin and levofloxacin group, respectively (P= 0.35). Bloodstream infections by Gram-positive bacteria were recorded in one (3%) case in the garenoxacin group and 25 (21%) cases in the levofloxacin group (P< 0.01). In contrast, bloodstream infections by Gram-negative microorganisms were identified in five (4%) cases in the levofloxacin group and eight (22%) cases in the garenoxacin group (P< 0.01).ConclusionsThese results indicate that there may be substantial differences in the antimicrobial spectrum between different fluoroquinolones. Although there are several biases due to rather small sample size and the retrospective nature, we should take the differences into consideration when we administer a prophylactic fluoroquinolone to a patient with hematological disease.