Ciprofloxacin prophylaxis in kidney transplant recipients reduces BK virus infection at 3 months but not at 1 year

David Wojciechowski, Ranjan Chanda, Sindhu Chandran, Brian Lee, Allison Webber, Melanie MacAraig, Stephen Tomlanovich, Flavio Vincenti

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

BACKGROUND: BK polyomavirus (BKV) infection remains a significant cause of nephropathy and graft loss. Fluoroquinolones inhibit BKV replication in vitro, and small studies suggest in vivo benefit. A strategy of fluoroquinolone prophylaxis directed specifically against BKV has not been formally tested against a control group in kidney transplant recipients. METHODS: We retrospectively compared the impact of a change in antibiotic prophylaxis practice from no BKV prophylaxis (Group 1, n=106, July-December 2009) to BKV prophylaxis with ciprofloxacin 250 mg twice daily for 30 days (Group 2, n=130, January-June 2010) on the rate of BKV infection during the first 12 months after kidney transplantation. RESULTS: Baseline demographics, transplant characteristics, induction immunosuppression, and 1-year incidence of acute rejection were similar between groups. Group 1 had fewer patients on maintenance corticosteroids (65.1% vs. 83.2%, P=0.002). At 3 months, Group 1 had a significantly higher risk of developing BK viremia (0.161 vs. 0.065, P=0.0378) and viruria (0.303 vs. 0.146, P=0.0067) compared with Group 2, but this difference disappeared at 12 months for both viremia (0.297 vs. 0.261, P=0.6061) and viruria (0.437 vs. 0.389, P=0.5363). Adjusting for the difference in steroid use did not change the results. There was a trend toward higher incidence of biopsy-proven BKV nephropathy in Group 1 (4.7% vs. 0.8%, P=0.057). CONCLUSION: Thirty-day ciprofloxacin prophylaxis in kidney transplant recipients is associated with a lower rate of BKV infection at 3 months but not at 12 months. The long-term effectiveness and optimal duration of fluoroquinolone prophylaxis against BKV infection remain unknown.

Original languageEnglish (US)
Pages (from-to)1117-1123
Number of pages7
JournalTransplantation
Volume94
Issue number11
DOIs
StatePublished - Dec 15 2012
Externally publishedYes

Keywords

  • BK virus
  • Ciprofloxacin
  • Fluoroquinolones
  • Kidney transplant

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Ciprofloxacin prophylaxis in kidney transplant recipients reduces BK virus infection at 3 months but not at 1 year'. Together they form a unique fingerprint.

  • Cite this

    Wojciechowski, D., Chanda, R., Chandran, S., Lee, B., Webber, A., MacAraig, M., Tomlanovich, S., & Vincenti, F. (2012). Ciprofloxacin prophylaxis in kidney transplant recipients reduces BK virus infection at 3 months but not at 1 year. Transplantation, 94(11), 1117-1123. https://doi.org/10.1097/TP.0b013e31826ec74e