Therapeutic Use of Quinolones in Oncology

  • G. Maschmeyer
Conference paper


Infections represent the major cause of mortality in neutropenic cancer patients. As shown in Table 1, infections alone or in combination with bleedings contribute to fatal outcome in patients with acute leukemias in about 70% of treatment failures [1–7].


Acute Leukemia Neutropenic Patient Neutropenic Cancer Patient Granulocytopenic Patient Oral Prophylaxis 
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  1. 1.
    Hersh EM, Bodey GP, Nies BA, Freireich EJ (1965) Causes of death in acute leukemia. A ten-year study of 414 patients from 1954–1963. JAMA 193:99–103Google Scholar
  2. 2.
    Schimpff SC, Young VM, Greene WH, Vermeulen GD, Moody MR, Wiernik PH (1972) Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Ann Intern Med 77:707–714PubMedGoogle Scholar
  3. 3.
    Inagaki J, Rodriguez V, Bodey GP (1974) Causes of death in cancer patients. Cancer 33:568–573PubMedCrossRefGoogle Scholar
  4. 4.
    Chang HY, Rodriguez V, Narboni G, Bodey GP, Luna MA, Freireich EJ (1976) Causes of death in adults with acute leukemia. Medicine 55:259–268PubMedCrossRefGoogle Scholar
  5. 5.
    Brown AE (1984) Neutropenia, fever, and infection. Am J Med 76:421–428PubMedCrossRefGoogle Scholar
  6. 6.
    Estey EH, Keating MJ, McCredie KB, Bodey GP, Freireich EJ (1982) Causes of initial remission induction failure in acute myelogenous leukemia. Blood 50:309–315Google Scholar
  7. 7.
    O’Hanley P, Easaw J, Rugo H, Easaw S (1989) Infectious disease management of adult leukemic patients undergoing chemotherapy: 1982 to 1986 experience at Stanford University Hospital. Am J Med 87:605–613PubMedCrossRefGoogle Scholar
  8. 8.
    Fernandes PB (1988) Mode of action, and in vitro and in vivo activities of the fluoroquinolones. J Clin Pharmacol 28:156–168PubMedGoogle Scholar
  9. 9.
    Stoning RA, Jameson B, McElwain TJ, Wiltshaw E (1977) Oral non-absorbable antibiotics prevent infection in acute non-lymphoblastic leukaemia. Lancet II:837-840Google Scholar
  10. 10.
    Gurwith MJ, Brunon JL, Lank BA, Harding GKM, Ronald AR (1979) A prospective controlled investigation of prophylactic trimethoprim/sulfamethoxazole in hospitalized granulocytopenic patients. Am J Med 66:248–256PubMedCrossRefGoogle Scholar
  11. 11.
    Kauffman CA, Liepman MK, Bergman AG, Mioduszewski J (1983) Trimethoprim/sulfamethoxazole prophylaxis in neutropenic patients. Reduction of infections and effect on bacterial and fungal flora. Am J Med 74:599–607Google Scholar
  12. 12.
    Gualtieri RJ, Donowitz GR, Kaiser DL, Less CE, Sande MA (1983) Double-blind randomized study of prophylactic trimethoprim/sulfamethoxazole in granulocytopenic patients with hematologic malignancies. Am J Med 74:934–940PubMedCrossRefGoogle Scholar
  13. 13.
    EORTC International Antimicrobial Cooperative Group (1984) Trimethoprim-sulfamethoxazole in the prevention of infection in neutropenic patients. J Infect Dis 150:372–379CrossRefGoogle Scholar
  14. 14.
    Karp JE, Merz WG, Hendricksen C, Laughon B, Redden T, Bamberger BJ, Bartlett SG, Sral R, Burke PJ (1987) Oral norfloxacin for prevention of gram-negative bacterial infections in patients with acute leukemia and granulocytopenia. Ann Intern Med 106:1–7PubMedGoogle Scholar
  15. 15.
    Winston DJ, Ho WG, Nakao SL, Gale RP, Champlin RE (1986) Norfloxacin versus vancomycin/polymyxin for prevention of infections in granulocytopenic patients. Am J Med 80:884–890PubMedCrossRefGoogle Scholar
  16. 16.
    Kern W, Kurrle E (1991) Ofloxacin versus trimethoprim-sulfamethoxazole for prevention of infection in patients with acute leukemia and granulocytopenia. Infection 19:73–80PubMedCrossRefGoogle Scholar
  17. 17.
    Dekker AW, Rozenberg-Arska M, Verhoef J (1987) Infection prophylaxis in acute leukemia: a comparison of ciprofloxacin with trimethoprim-sulfamethoxazole and colistin. Ann Intern Med 106:7–12PubMedGoogle Scholar
  18. 18.
    Donnelly JP, Maschmeyer G, Daenen S on behalf of the EORTC—Gnotobiotic Project Group (1992) Selective oral antimicrobial prophylaxis for the prevention of infection in acute leukemia—ciprofloxacin versus co-trimoxazole plus colistin. Eur J Cancer 28A:873–878PubMedCrossRefGoogle Scholar
  19. 19.
    Rozenberg-Arska M, Dekker AW, Verdonck L, Verhoef J (1989) Prevention of bacteremia caused by α-hemolytic streptococci by roxithromycin (RU-28965) in granulocytopenic patients receiving ciprofloxacin. Infection 17:240–243PubMedCrossRefGoogle Scholar
  20. 20.
    Warren RE, Wimperis JZ, Baglin TP, Constantine CE, Marcus R (1990) Prevention of infection by ciprofloxacin in neutropenia. J Antimicrob Chemother 26 [Suppl F]:109–123PubMedGoogle Scholar
  21. 21.
    EORTC International Antimicrobial Therapy Cooperative Group (1992) A prospective double-blind study of pefloxacin plus penicillin V or placebo for prophylaxis of bacterial infection in granulocytopenic cancer patients. 32nd Inter-science Conference on Antimicrobial Agents and Chemotherapy, Anaheim, abstract no 1692Google Scholar
  22. 22.
    Maschmeyer G, Rosenthal E, Wendt F (1989) Bacteriologic surveillance during long-term administration of 4-quinolones. Rev Infect Dis 11 [Suppl 5]:S1238–S1239Google Scholar
  23. 23.
    Paul Ehrlich Society Study Group (1994) Interventional antimicrobial strategy in febrile neutropenic patients with hematological malignancies—results of a three step randomized multicenter study. Ann Hematol (in press)Google Scholar
  24. 24.
    Maschmeyer G, Haralambie E, Gaus W, Kern W, Dekker AW, De Vries-Hospers HG, König W, Gutzler F, Daenen S (1988) Ciprofloxacin and norfloxacin for selective decontamination in patients with severe granulocytopenia. Infection 16:98–104PubMedCrossRefGoogle Scholar
  25. 25.
    Rolston KVI, Haron E, Cunningham C, Bodey GP (1989) Intravenous ciprofloxacin for infections in cancer patients. Am J Med 87 [Suppl 5A]:261–265CrossRefGoogle Scholar
  26. 26.
    Bayston KF, Want S, Cohen J (1989) A prospective, randomized comparison of ceftazidime and ciprofloxacin as initial empiric therapy in neutropenic patients with fever. Am J Med 87 [Suppl 5A]:269–273CrossRefGoogle Scholar
  27. 27.
    Meunier F, Zinner SH, Gaya H, Calandra T, Viscoli C, Klastersky J, Glauser M, and the European Organization for Research on Treatment of Cancer International Antimicrobial Therapy Cooperative Group (1991) Prospective randomized evaluation of ciprofloxacin versus piperacillin plus amikacin for empiric antibiotic therapy of febrile granulocytopenic cancer patients with lymphomas and solid tumors. Antimicrob Agents Chemother 35:873–878PubMedGoogle Scholar
  28. 28.
    Johnson PRE, Liu Yin JA, Tooth JA (1992) A randomized trial of high-dose ciprofloxacin versus azlocillin and netilmicin in the empirical therapy of febrile neutropenic patients. J Antimicrob Chemother 30:203–214PubMedCrossRefGoogle Scholar
  29. 29.
    Chan CC, Oppenheim BA, Anderson H, Swindell R, Scarffe JH (1989) Randomized trial comparing ciprofloxacin plus netilmicin versus piperacillin plus netilmicin for empiric treatment of fever in neutropenic patients. Antimicrob Agents Chemother 33:87–91PubMedGoogle Scholar
  30. 30.
    Kelsey SM, Wood ME, Shaw E, Newland AC (1989) Intravenous ciprofloxacin as empirical treatment of febrile neutropenic patients. Am J Med 87 [Suppl 5A]:274–277CrossRefGoogle Scholar
  31. 31.
    Flaherty JP, Weitley D, Edlin B, George D, Arnow P, O’Keefe P, Weinstein RA (1989) Multicenter randomized trial of ciprofloxacin plus azlocillin versus ceftazidime plus amikacin for empiric treatment of febrile neutropenic patients. Am J Med 87 [Suppl 5A]:278–282CrossRefGoogle Scholar
  32. 32.
    Philpott-Howard JN, Barker KF, Wade JJ, Kaczmarski RS, Smedley JC, Mufti GJ (1990) Randomized multicentre study of ciprofloxacin and azlocillin versus gentamicin and azlocillin in the treatment of febrile neutropenic patients. J Antimicrob Chemother 26 [Suppl F]:89–99PubMedGoogle Scholar
  33. 33.
    Kelsey SM, Collins PW, Delord C, Weinhard B, Newland AC (1990) A randomized study of teicoplanin plus ciprofloxacin versus gentamicin plus piperacillin for the empirical treatment of fever in neutropenic patients. Br J Haematol 76 [Suppl 2]:10–13PubMedCrossRefGoogle Scholar
  34. 34.
    Malik IA, Abbas Z, Karim M (1992) Randomised comparison of oral ofloxacin alone with combination of parenteral antibiotics in neutropenic febrile patients. Lancet 339:1092–1096PubMedCrossRefGoogle Scholar
  35. 35.
    Rubenstein EB, Rolston K, Benjamin RS, Loewy J, Escalante C, Manzullo E, Hughes P, Moreland B, Fender A, Kennedy K, Holmes F, Elting L, Bodey GP (1993) Outpatient treatment of febrile episodes in low-risk neutropenic patients with cancer. Cancer 71:3640–3646PubMedCrossRefGoogle Scholar
  36. 36.
    Hughes WT, Armstrong D, Bodey GP, Feld R, Mandell GL, Meyers JD, Pizzo PA, Schimpff SC, Shenep JL, Wade JC, Young LS, Yow MD (1990) Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. J Infect Dis 161:381–396PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1994

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  • G. Maschmeyer

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