Ofloxacin versus vancomycin/polymyxin for prevention of infection in granulocytopenic patients

Granulocytopenia is an abnormal decrease in granulocytes, a type of white blood cell in the bone marrow. The disease is often associated with bacterial infections and can be controlled by antibiotics. Under normal conditions, the gastrointestinal tract has anaerobic bacteria, which prevent the growth of aerobic bacteria, that is, bacteria that require oxygen to thrive. Ofloxacin is an antibiotic that specifically attacks aerobic bacteria, such as gram-negative bacilli and gram-positive cocci, but preserves the natural anaerobic bacteria in the gastrointestinal tract. The effectiveness and safety of ofloxacin were compared with that of the antibiotic mixture vancomycin/polymyxin in treating bacterial infections in 62 patients with granulocytopenia. There were fewer numbers of gram-negative bacilli organism per patient, fewer patients with infection, and fewer cases of septicemia, or bacteria in the blood, in the group receiving ofloxacin than those receiving the antibiotic mixture. Ofloxacin was also better tolerated and caused fewer side effects. However, neither of the antibiotic preparations could eliminate infection by viridans group streptococci, coagulase-negative staphylococci, or other gram-positive organisms. Three types of bacteria that were resistant to inactivation by ofloxacin were isolated but did not cause infections. The results show that ofloxacin is a more effective and tolerable antibiotic than vancomycin/polymyxin for the prevention of infections by gram-negative bacteria in granulocytopenic patients, although more effective treatment is needed to prevent gram-positive infections.