Prevention of febrile leucopenia after chemotherapy in high-risk breast cancer patients: no significant difference between granulocyte-colony stimulating growth factor or ciprofloxacin plus amphotericin B

J Antimicrob Chemother. 1999 May;43(5):741-3. doi: 10.1093/jac/43.5.741.

Abstract

In a prospective randomized trial, 40 stage IV breast cancer patients undergoing intermediate high-dose chemotherapy (cyclophosphamide, 5-fluorouracil plus epirubicin or methotrexate), received either recombinant human G-CSF (rhG-CSF, group I) or ciprofloxacin and amphotericin B (CAB, group II) for prevention of febrile leucopenia (FL). In group I, seven of 18 patients developed FL (after 10/108 courses); in group II, seven of 22 patients (7/98 courses) (P = NS). Median hospitalization duration and costs were not different. RhG-CSF was 6.6 times more expensive per course than CAB. In conclusion, prophylactic CAB has similar efficacy to rhG-CSF in this setting, and is more cost-effective.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amphotericin B / economics
  • Amphotericin B / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Ciprofloxacin / economics
  • Ciprofloxacin / therapeutic use*
  • Costs and Cost Analysis
  • Cyclophosphamide / administration & dosage
  • Drug Therapy, Combination
  • Epirubicin / administration & dosage
  • Female
  • Fever / complications
  • Fever / prevention & control
  • Fluorouracil / administration & dosage
  • Granulocyte Colony-Stimulating Factor / economics
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Length of Stay / economics
  • Leukopenia / chemically induced
  • Leukopenia / prevention & control*
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm Metastasis
  • Netherlands
  • Prospective Studies
  • Recombinant Proteins / economics
  • Recombinant Proteins / therapeutic use

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Epirubicin
  • Ciprofloxacin
  • Amphotericin B
  • Cyclophosphamide
  • Fluorouracil
  • Methotrexate