Long-term Oral Ciprofloxacin for Infection Prophylaxis in Allogeneic Bone Marrow Transplantation

The efficacy of oral ciprofloxacin to prevent bacterial infections during the first three months after allogeneic bone marrow transplantation (BMT) was assessed prospectively. Twenty-three recipients of lymphocyte depleted marrow grafts received ciprofloxacin orally, 500 mg twice daily for 90 days after BMT. Nine patients had no infections during ciprofloxacin prophylaxis; in the remaining 14 patients 19 febrile episodes occurred. No infections could be attributed to Gram-negative rods nor to fungal micro-organisms on the basis of the micro-organisms isolated. One infection, a pneumonia due to Bacteroides melaninogenicus, proved to be fatal. Allergic skin reactions were observed in three patients, but neither hematological nor nephrological side-effects could be substantiated in patients who were treated concomitantly with cyclosporine. Prolonged administration of ciprofloxacin turned out to be safe and effective in preventing serious aerobic bacterial infections during the first three months after BMT.