Neutropenic Cancer Patients

Various fluoroquinolones have been used for empirical treatment of fever in neutropenic cancer patients. For ciprofloxacin, monotherapy produced less favorable results than ceftazidime alone or combination therapies [77], whereas combination therapy gave results similar to those with standard regimes [78]. Oral regimes including ciprofloxacin also proved cheaper than parenteral combinations. Resistance among E. coli and superinfection with Gram-positive pathogens appear likely to limit such therapy.

Since the original reports of improved efficacy of fluoroquinolones for prevention of infection in neutropenic patients compared to standard therapy [79,80], these agents—notably norfloxacin, ciprofloxacin, and ofloxacin—have become agents of choice. However, reports of fluoroquinolone-resistant E. coli causing bacteremia in these patients has again compromised therapy in many countries [28-31].

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