Single-drug oral antibacterial prophylaxis with ofloxacin in BMT recipients

We evaluated the efficacy and safety of a new oral fluoroquinolone, ofloxacin (200 mg twice daily), as antibacterial prophylaxis after BMT in a non-comparative prospective study of patients nursed in either LAF plastic isolators or HEPA filtered single rooms. Of the 101 evaluable patients who were neutropenic (< 500 x 10(6)/l) for a median duration of 20 days, 92 (91%) had febrile episodes of varying length and causes. Infections were documented in 34 patients, of whom 14 had proven bacterial infection (13 with bacteremia and one with pneumonia). Mortality rate within 6 weeks after transplant was 6%. Only one patient died from bacterial infection. Univariate analysis using an array of potentially prognostic factors including the type of isolation was not helpful in identifying significant variables for predicting the development of documented infection. Tolerance was excellent. Oral ofloxacin was associated with a relatively low incidence of documented bacterial infection and related mortality, although it did not obviate the need for frequent empiric antimicrobial therapy due to a high incidence of febrile episodes.