Fluoroquinolone prophylaxis for bacterial infections in neutropenic patients with hematologic malignancies.

INTRODUCTION: The use of fluoroquinolones as prophylaxis for bacterial infections in patients with chemotherapy induced neutropenia is debatable. The present study was conducted to assess the prophylactic efficacy of fluoroquinolones in adult neutropenic patients with hematologic malignancies. MATERIALS AND METHODS: For the period 1994 through 2000 a prospective, randomized trial was conducted at the University Clinic of Hematology (Medical University, Plovdiv). Two groups of patients were included--experimental group, consisting of 36 patients with 41 granulocytopenic episodes and a control group of 34 patients with 41 granulocytopenic episodes. Non parametrical and psi methods were used for statistical analysis. Kaplan-Meier test was employed to determine patients' survival rate. Comparison of survival rates between the two groups was performed using the log-rank test. RESULTS: A statistically significant difference between the two groups was found in the number of infection-free neutropenic episodes (P < 0.001), in infection-related mortality rate (p = 0.001) and mortality rate within 1 month of the onset of infection (p < 0.001). Difference in long term survival rates was not statistically significant (p > 0.05). CONCLUSIONS: Prophylaxis with fluoroquinolones reduced the occurrence of infection in adult neutropenic patients without affecting the long-term survival. Moreover, it is especially beneficial for patients with severe neutropenia and during the active phase of the disease.

The character of growth of mycobacterium tuberculosis in vitro in dependence on peripheral human blood's components.

Blood plasma, cell mass, white blood cells (WBC) and erythrocytes were investigated for their relation to cord formation of M. tuberculosis, cultivated in blood according to Pryce's method. It was found that cord formation was related to blood cell and followed the zone of sedimentation of WBC. In lysed blood cord formation could be revealed on the whole glass surface, but disappeared if the lysed blood was filtered through Seitz filter - evidences which were accepted as indications that cord formation was dependent on WBC. However, destroying WBC in lysed blood by freezing and thawing or eliminating them by centrifugation did not disturb cord formation and addition of WBC to simple media did not result in cord formation. It was concluded that cord formation was called forth by lysed erythrocytes and this was confirmed through adding erythrocytes stromata to simple media, where cord formation appeared. The practical value of the technique applied and the eventual role of erythrocyte stromata's lipids in cord formation are discussed.