Norfloxacin for prevention of bacterial infections in granulocytopenic patients

Winston, Drew J.; Ho, Winston G.; Champlin, Richard E.; Karp, Judith E.; Bartlett, John D.; Finley, Rebecca S.; Joshi, Jai H.; Talbot, George H.; Levitt, Lee J.; Deresinski, Stan; Corrado, Michael L.

doi:10.1016/0002-9343(87)90617-6

Cited by 62 publications

(33 citation statements)

References 20 publications

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“…SD is the selective complete suppression of aerobic Gram-negative bacilli in the digestive tract, while maintaining the protective indigenous anaerobic microflora intact (Sleijfer et al 1980;Winston et al 1987).…”

Section: Introductionmentioning

confidence: 99%

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A norfloxacin dose finding study for selective decontamination of the digestive tract in pigs

Waaij

Messerschmidt²,

Waaij³

1989

Epidemiol. Infect.

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SUMMARYFive pigs were treated orally with norfloxacin for 5 consecutive days in two wellseparated periods. This was done to determine the lowest dose required to free the pigs of Enterobacteriaceae. In the first period of the study, the animals were treated with 400 mg per day while in the second treatment 800 mg norfloxacin was given. Daily faecal culturing indicated that the faeces became free of Enterobacteriaceae in 3-5 days when treated with 400 mg/day, while all animals were found negative on culturing after 3 days of treatment with 800 mg/day. Investigation of the concentration of norfloxacin in the faeces revealed that a substantial fraction of the dose was either absorbed or inactivated by faecal substances. An in vitro study in faeces confirmed that a substantial part, some 75 % of the dose, may have been inactivated by intestinal contents. This finding helps to explain the much lower concentration of 120 mg norfloxacin per kg of faeces in the pig in comparison with the almost tenfold higher concentration reported to develop in man during treatment with an identical dose.

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Section: Introductionmentioning

confidence: 99%

“…In addition, norfloxacin has recently been found very effective and safe for SD in man (Pecquet, Andremont & Tancrede, 1985;Winston et al 1987;Edlund et al 1987). However, regardless of its apparent safety, there remains a question concerning the maintenance of the indigenous intestinal flora.…”

Section: Introductionmentioning

confidence: 99%

A norfloxacin dose finding study for selective decontamination of the digestive tract in pigs

Waaij

Messerschmidt²,

Waaij³

1989

Epidemiol. Infect.

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“…Moreover, gram-negative bacterial infections occurred significantly less often in the norfloxacin-treated group (0% to 1 1.4%) (6)(7)(8) compared with the control group (24%, 39%) (7,8) and the group which received non-absorbable antibiotics (16.7%) (6). In the report of Karp et al (8), the mean number of days from starting the chemotherapy to the first febrile episode was longer in the norfloxacin group, and the meannumberof days with a fever during the study period was lower in the norfloxacin group compared with the control group.…”

Section: Discussionmentioning

confidence: 96%

“…Previous reports showed that the number of patients with bacteriologically-documented infections in norfloxacin-treated patients was lower (24% to 44%) (3,6,7,9) compared with the control group (57%) (7) and the group which received nonabsorbable antibiotics (67%) (6). Moreover, gram-negative bacterial infections occurred significantly less often in the norfloxacin-treated group (0% to 1 1.4%) (6)(7)(8) compared with the control group (24%, 39%) (7,8) and the group which received non-absorbable antibiotics (16.7%) (6).…”

Section: Discussionmentioning

confidence: 97%

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Prevention of Bacterial and Fungal Infections in Acute Leukemia Patients: A New and Potent Combination of Oral Norfloxacin and Amphotericin B.

1993

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The effect of a combination regimen using norfloxacin (NFLX)and amphotericin B (AMPH-B) for prevention ofinfections in patients with acute leukemia being treated by remission-induction chemotherapy in a randomized, controlled trial was studied. One hundred and six consecutive, evaluable patients were randomly assigned to receive orally 200 mg of norfloxacin two or four times daily and 200 mg of amphotericin B four times daily, or amphotericin B only. A smaller percentage of patients with bacteriologically-documented infections was observed in the study group compared with the control group (34.6% vs 56.9%; P<0.05). The mean number of days that the patients received empirical antibiotic therapy was shorter in the study group (23 days vs 30 days; P<0.05). The percentage of patients with a gram-negative bacterial infection (9.6% vs 27.5% ; P<0.05) or a fungal infection (17.3% vs 37.3% ; P<0.05) was decreased in the study group. This newcombination antimicrobial regimen is safe and effective for prevention of gram-negative bacterial as well as fungal infections in patients with acute leukemia being treated with cytotoxic remission-induction chemotherapy. (Internal Medicine 32: 710-715, 1993)

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Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy

Gafter‐Gvili¹,

Fraser²,

Wetering³

et al. 2005

Cochrane Database of Systematic Reviews

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Our review demonstrated that prophylaxis significantly reduced all-cause mortality. The most significant reduction in mortality was observed in trials assessing prophylaxis with quinolones. The benefit demonstrated in our review outweighs harm, such as adverse effects, and development of resistance, since all-cause mortality is reduced. Since most trials in our review were of patients with haematologic cancer, prophylaxis, preferably with a quinolone, should be considered for these patients.

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Norfloxacin for prevention of bacterial infections in granulocytopenic patients

Cited by 62 publications

References 20 publications

A norfloxacin dose finding study for selective decontamination of the digestive tract in pigs

A norfloxacin dose finding study for selective decontamination of the digestive tract in pigs

Prevention of Bacterial and Fungal Infections in Acute Leukemia Patients: A New and Potent Combination of Oral Norfloxacin and Amphotericin B.

Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy

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