The impact of rufloxacin given as prophylaxis to patients with cancer on their oral and faecal microflora

Abstract

A single dose of 200 mg/day rufloxacin was investigated for preventing infection and for its impact on the commensal flora in a pilot study of 62 patients undergoing cytotoxic treatment for cancer. No infection caused by Gram-negative bacilli occurred among 54 assessable patients but prophylaxis was replaced by empirical treatment for fever in 19 cases and because of an adverse event, in a further three cases. The remaining 32 patients completed prophylaxis. The number of oral Branhamella spp., faecal Enterobacteriaceae and Bacteriodes spp. were significantly reduced whereas there was little effect of rufloxacin on the numbers of the other oral and faecal microflora. However, resistance to rufloxacin increased among both oral viridans streptococci, coagulase negative staphylococci and the faecal enterococci. These preliminary data suggest that selective oral antimicrobial prophylaxis for patients with cancer might be achieved with once-daily rufloxacin.

Microflora in oral ecosystems in subjects with radiation‐induced hyposalivation

“…Antibiotic treatment might influence on the composition of the oral microflora (Brismar et al , 1993; D’Antonio et al , 1996). No controls who had taken antibiotics <3 months prior to the examination were included.…”

“…This stresses the importance of taking microbial samples at a suspected mucosal infection to identify the micro-organism or micro-organisms involved. Antibiotic treatment might influence on the composition of the oral microflora (Brismar et al, 1993;D'Antonio et al, 1996). No controls who had taken antibiotics <3 months prior to the examination were included.…”

Effects of treatment with antimicrobial agents on the human colonic microflora

“…By administration of different fluoroquinolones and enumeration of bacteria from different genera before and after exposure, it was shown that fluoroquinolones have a selective effect on the normal colonic bacteria. The effects of ciprofloxacin (Brismar et al 1990), norfloxacin (Edlund et al 1987a, 1987b; Edlund and Nord 1988a), ofloxacin (Pecquet et al 1987; Edlund et al 1988), pefloxacin (Vollaard et al 1992), lomefloxacin (Edlund et al 1990), levofloxacin (Edlund et al 1997b), sparfloxacin (Ritz et al 1994), rufloxacin (D’Antonio et al 1996), sitafloxacin (Inagaki and Yamamoto et al 1995), gatifloxacin (Edlund and Nord 1999a), trovafloxacin (Edlund and Nord 1999b), and moxifloxacin (Edlund and Nord 1999b; Edlund et al 2000b) on the intestinal microflora have been analyzed. All of the fluoroquinolones tested decreased the populations of enterobacteria, and pefloxacin decreased the number of aerobic Gram-positive cocci.…”

Comparative in vitro Activity of Levofloxacin and Ciprofloxacin against Bacterial Isolates from Neutropenic Patients

“…Agents such as ciprofloxacin, norfloxacin and ofloxacin are used in most large cancer treatment centres for antimicrobial prophylaxis in high-risk patients with prolonged neutropenia, including patients with acute leukaemia undergoing remission induction chemotherapy, and recipients of bone marrow transplantation [2][3][4][5].…”