Ciprofloxacin for BK viremia prophylaxis in kidney transplant recipients: Results of a prospective, double-blind, randomized, placebo-controlled trial

Patel, Samir J.; Knight, Richard J.; Kuten, Samantha A.; Graviss, Edward A.; Nguyen, Duc T.; Moore, Linda W.; Musick, William L.; Gaber, A. Osama

doi:10.1111/ajt.15328

Cited by 20 publications

(16 citation statements)

References 17 publications

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“…Prophylactic fluoroquinolone use does not decrease the rate of BKV infection and increases the risk for bacterial resistance. 129 , 130 , 131 Furthermore, a prospective, multicenter, double-blind, placebo-controlled trial in patients with BK viremia found that a 30-day course of levofloxacin did not significantly improve allograft function or BK viral load reduction. 106 …”

Section: Managementmentioning

confidence: 99%

Advances in BK Virus Complications in Organ Transplantation and Beyond

et al. 2020

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Reactivation of BK virus (BKV) remains a dreaded complication in immunosuppressed states. Conventionally, BKV is known as a cause for BKV-associated nephropathy and allograft dysfunction in kidney transplant recipients. However, emerging studies have shown its negative impact on native kidney function and patient survival in other transplants and its potential role in diseases such as cancer. Because BKV-associated nephropathy is driven by immunosuppression, reduction in the latter is a convenient standard of care. However, this strategy is risk prone due to the development of donor-specific antibodies affecting long-term allograft survival. Despite its pathogenic role, there is a distinct lack of effective anti-BKV therapeutics. This limitation combined with increased morbidity and health care cost of BKV-associated diseases add to the complexity of BKV management. While summarizing recent advances in the pathogenesis of BKV-associated nephropathy and its reactivation in other organ transplants, this review illustrates the limitations of current and emerging therapeutic options and provides a compelling argument for an effective targeted anti-BKV drug.

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Section: Managementmentioning

confidence: 99%

Advances in BK Virus Complications in Organ Transplantation and Beyond

et al. 2020

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“…only one study examined the use of fluoroquinolone for treatment in 39 KT patients with BK viremia 17 ; thus, we focused on the prophylactic effect. Finally, three trials with 281 patients post HSCT [18][19][20] and 11 trials with 1882 patients post KT [21][22][23][24][25][26][27][28][29][30][31] fulfilled the criteria for this meta-analysis. Flow diagram is shown in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…Three of them were randomized controlled trials, [21][22][23] and only abstract was available for 6 studies. 23,[27][28][29][30][31] The threshold of BKV-DNA PCR of the urine and blood differed from each study.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Data of 1495 patients from 9 studies were eligible for the analysis about BKVAN within 1 year post KT. [21][22][23][24][25][26][27][28]31 There was no significant difference in OR with no significant heterogeneity (0.74, 95% CI: 0.35-1.55, I 2 = 11%, P = .35) (Figure 3).…”

Section: Incidence Of Bkvan Post Ktmentioning

confidence: 99%

“…Heterogeneity was significantly high (I 2 = 58%, P < .01). When we extracted only randomized controlled trials, [21][22][23] OR was 1.37 (95% CI: 0.61-3.10, I 2 = 35%, P = .21). In order to assess the heterogeneity, we performed subgroup analysis by therapy duration and type of fluoroquinolone, but each subgroup showed no significant difference of ORs and remained high heterogeneity.…”

Section: Incidence Of Bk Viremia Post Ktmentioning

confidence: 99%

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