Addition of doxycycline to ciprofloxacin for infection prophylaxis during autologous stem cell transplants for multiple myeloma

Sivik, Jeffrey; Davidson, Jo Ann; Hale, Cory M.; Talamo, Giampaolo

doi:10.1007/s00520-018-4165-6

Cited by 4 publications

(9 citation statements)

References 30 publications

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“…Certain antibiotics (e.g., doxycycline, fluoroquinolones, rifabutin, nitroxoline, etc.) have been shown to exhibit anti-cancer activity and have been studied in clinical trials [ 29 - 32 ]. Like many forms of cancer, including colorectal cancer (CRC), angiogenesis is an important pathway in tumorigenesis.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Gastrointestinal Cancers in Cirrhotic Patients Receiving Rifaximin vs Lactulose Only Therapy for Hepatic Encephalopathy

Patel¹,

Li²,

Minacapelli³

et al. 2023

Cureus

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Background Rifaximin and/or lactulose therapy is widely used in cirrhotic patients for the prevention and treatment of hepatic encephalopathy. The incidence of gastrointestinal cancers in these patients on lactulose, rifaximin, and/or combination therapy is unknown. We investigated the possible effect of lactulose and rifaximin on cancer risk in patients with cirrhosis using the MarketScan database. Methods A retrospective cohort study was conducted using the Truven Health MarketScan Commercial Claims databases from 2007-2017. An index date was defined for each participant as the earliest date of cirrhosis diagnosis. A baseline period for each participant was defined as the 12 months prior to the first medication date while the study follow-up period represented the period from the initiation of the medication to its cessation. ANOVA was used to compare all continuous measures of age and duration of medication. Wald Chi-square tests were performed to test the associations between the study groups. Results A total of 12,409 patients were included in our study. The rifaximin only cohort had the greatest reduction in risk of developing colon cancer, esophageal cancer, and stomach cancer compared to the other groups. Rifaximin reduced the risk of colon cancer and esophageal cancer by 59.42% and 70.37%, respectively, compared to patients taking lactulose only. Patients in the lactulose plus rifaximin cohort had the highest rate of development of pancreatic cancer (lactulose plus rifaximin vs rifaximin only vs lactulose only, 0.45% vs 0.24% vs 0.21%; P < 0.0001) and liver and intrahepatic bile duct cancers (11.73% vs 5.84% vs 5.49%; P < 0.0001). Conclusion Colon, esophageal, and gastric cancers had a marked incidence reduction in the rifaximin only cohort compared to the other cohorts studied.

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Section: Discussionmentioning

confidence: 99%

Reduction in Gastrointestinal Cancers in Cirrhotic Patients Receiving Rifaximin vs Lactulose Only Therapy for Hepatic Encephalopathy

Patel¹,

Li²,

Minacapelli³

et al. 2023

Cureus

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“…We aimed to identify novel repurposable drugs that could increase the cytotoxicity of antimitotic drugs to P-gp-overexpressing drug-resistant cancer cells. Various antibiotic drugs can be used in cancer therapy [14,15,17]. Thus, we attempted to identify novel repositioned drugs from antibiotics and determine whether the co-treatment of various antibiotics could increase the cytotoxicity of antimitotic drugs in drug-resistant KBV20C cancer cells.…”

Section: Vic + Rifabutin Exhibits Increased Cytotoxicity In P-gp-over...mentioning

confidence: 99%

“…Antibiotics (doxycycline, levofloxacin, fluoroquinolones, nitroxoline, rifabutin, etc.) exhibit anticancer activity and have been used in clinical trials as repositioned drugs for cancer patients [14][15][16][17]. Further, we evaluated antibiotics with potential cytotoxic effects when administered as a co-treatment with antimitotic drugs.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Rifabutin Increases Cytotoxicity in Antimitotic-Drug-Treated Resistant Cancer Cells by Exhibiting Strong P-gp-Inhibitory Activity

Lee

Kim

et al. 2022

IJMS

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The cytotoxicity of various antibiotics at low doses in drug-resistant cancer cells was evaluated. Low doses of rifabutin were found to markedly increase the cytotoxicity of various antimitotic drugs, such as vincristine (VIC), to P-glycoprotein (P-gp)-overexpressing antimitotic-drug-resistant KBV20C cells. Rifabutin was also found to exert high levels of P-gp-inhibitory activity at 4 and 24 h posttreatment, suggesting that the cytotoxicity of VIC + rifabutin was mainly due to the direct binding of rifabutin to P-gp and the reduction of VIC efflux by P-gp. The combination of VIC + rifabutin also increased early apoptosis, G2 arrest, and the DNA damaging marker, pH2AX protein. Interestingly, only the combination of VIC + rifabutin induced remarkable levels of cytotoxicity in resistant KBV20C cells, whereas other combinations (VIC + rifampin, VIC + rifapentine, and VIC + rifaximin) induced less cytotoxicity. Such finding suggests that rifabutin specifically increases the cytotoxicity of VIC in KBV20C cells, independent of the toxic effect of the ansamycin antibiotic. Only rifabutin had high P-gp-inhibitory activity, which suggests that its high P-gp-inhibitory activity led to the increased cytotoxicity of VIC + rifabutin. As rifabutin has long been used in the clinic, repositioning this drug for P-gp-overexpressing resistant cancer could increase the availability of treatments for patients with drug-resistant cancer.

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“…On the contrary, a randomized phase III study that included 212 MM patients undergoing induction therapy showed that the prophylactic use of antibiotics did not decrease the incidence of serious bacterial infections, thus obviating the need for the routine use of antibacterial prophylaxis in Update on Multiple Myeloma patients with MM receiving induction therapy [76]. However, other studies have shown that the addition of doxycycline to ciprofloxacin and the sequential use of levofloxacin followed by ertapenem in patients with MM subjected to autologous HSCT reduce the frequency of FN episodes, bacteremia, and documented bacterial infections without increasing the rate of serious complications [77,78].…”

Section: Bacterial and Bloodstream Infections In MMmentioning

confidence: 99%

Infections in Patients with Multiple Myeloma in the Era of Novel Agents and Stem Cell Therapies

Al-Jasser¹,

Al-Anazi²

2019

Update on Multiple Myeloma

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Multiple myeloma is a common hematologic malignancy that is associated with reduced cellular as well as humoral immunity ultimately causing various infectious complications. The recent advances in the management of myeloma have led not only to prolonged survival but also to shifts in the incidence as well as the spectrum of infections encountered. This book chapter will be an updated review on the infectious complications in patients with multiple myeloma in the era of novel agents, stem cell therapies, and monoclonal antibodies. It will cover causes of immunosuppression, timing, and types as well as management of the various infections reported with various therapeutic modalities that are currently utilized in the management of myeloma patients.

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Addition of doxycycline to ciprofloxacin for infection prophylaxis during autologous stem cell transplants for multiple myeloma

Abstract: The addition of doxycycline to standard prophylaxis with ciprofloxacin seems to reduce the number of NF episodes and documented bacterial infections in patients with MM undergoing ASCT, without increasing rate of serious complications.

Cited by 4 publications

References 30 publications

Reduction in Gastrointestinal Cancers in Cirrhotic Patients Receiving Rifaximin vs Lactulose Only Therapy for Hepatic Encephalopathy

Reduction in Gastrointestinal Cancers in Cirrhotic Patients Receiving Rifaximin vs Lactulose Only Therapy for Hepatic Encephalopathy

Low-Dose Rifabutin Increases Cytotoxicity in Antimitotic-Drug-Treated Resistant Cancer Cells by Exhibiting Strong P-gp-Inhibitory Activity

Infections in Patients with Multiple Myeloma in the Era of Novel Agents and Stem Cell Therapies

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