Prophylaxis with ofloxacin decreases the incidence of moderate-to-severe adverse effects from bacillus Calmette-Guérin (BCG) intravesical therapy in patients with superficial bladder cancer, French researchers reported. Ofloxacin is a fluoroquinolone with tuberculostatic properties.
Marc Colombel, MD, of Hôpital Edouard Herriot in Lyon, and his colleagues studied 115 patients with primary or recurrent superficial bladder cancer and no prior BCG treatment. Patients were randomly assigned to receive induction treatment with intravesical BCG and either 200 mg ofloxacin (group 1) or placebo (group 2). The BCG course consisted of one instillation a week for six consecutive weeks, followed by a drug-free period for six weeks, and then another round of three weekly instillations. The median follow-up was 369 and 374 days in groups 1 and 2, respectively.
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Ofloxacin recipients experienced an 18.5% decrease in class II or higher moderate and severe adverse events between instillations 4 and 6, the investigators reported in The Journal of Urology (2006;176:935-939). Ofloxacin also significantly lowered the percentage of Class III adverse events between instillations 1 and 9.