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Levofloxacin after kidney transplantation did not prevent infection
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Use of levofloxacin immediately after kidney transplantation may not prevent BK virus infection, according to data presented at the American Society of Nephrology’s Kidney Week meeting in Philadelphia.
Greg A. Knoll, MD, of the Ottawa Hospital Research Institute and University of Ottawa, and colleagues enrolled 154 patients receiving kidney-only transplant at seven transplant centers from December 2011 to June 2013. Participants were randomly assigned either a 3-month course of 500 mg levofloxacin daily (n=76) or placebo (n=78) within 5 days of transplantation. The primary endpoint was occurrence of BK virus in urine within 1 year of transplantation.
The mean follow-up time was 46.5 weeks in the intervention group and 46.3 weeks in the control group; follow-up for 27 participants was terminated due to lack of funding. BK viruria occurred in 29% of those assigned levofloxacin and 33.3% of participants assigned placebo (HR=0.91; 95% CI, 0.51-1.63).
No difference was seen between groups regarding the secondary endpoints of BK viremia, peak viral load, rejection and survival. The risk for resistant infection among isolates usually sensitive to quinolones, however, was greater in the intervention group than in controls (58.3% vs. 33.3%; RR=1.75; 95% CI, 1.01-2.98).
“Among kidney transplant recipients, a 3-month course of levofloxacin initiated early after transplantation did not prevent BK viruria,” the researchers concluded. “This intervention was associated with an increased risk of adverse events such as bacterial resistance. These findings do not support the use of levofloxacin to prevent post-transplantation BK virus infection.”
For more information:
Knoll GA. Abstract #SA-PO1091. Presented at: The American Society of Nephrology’s Kidney Week 2014; Nov. 11-16; Philadelphia.
Disclosure: See the study for a full list of financial disclosures.
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