BK polyomavirus (BKV) is a significant infection affecting renal transplant recipients. Previous data suggests possible activity of fluoroquinolones against BKV, although their role in preventing BK is unknown. The purpose of this study was to review 6-month experience using a ciprofloxacin (CIP) protocol specifically aimed at preventing BKV. Beginning in 03/2012, renal transplant recipients were discharged on ciprofloxacin 500 mg once daily for 90 days. Patients on antiarrythmic agents and those with CIP allergies were excluded. CIP patients were compared to a consecutive cohort of patients transplanted from 01/2011 to 03/2012 who did not receive CIP prophylaxis. A total of 327 patients (80-CIP and 247 noCIP) were reviewed. There were no differences in age, race, gender, donor type, and tacrolimus or mycophenolate use. There was a slightly higher rate of rATG induction (74% vs. 61%; p=0.04) and a lower rate of prednisone use (79% vs. 89%; p=0.02) in the CIP arm. BK related outcomes are shown below. A 27% reduction in BKV was seen at 6 months, though this did not reach statistical significance. No difference was seen in the rate of UTIs although 9 bacteremias occurred in noCIP patients compared to 0 in CIP patients (0.02). From the available susceptibility data, decreased rates of susceptibilities were seen among several antibiotic agents in CIP treated patients (fig.2). In conclusion, preliminary data suggests a modest reduction in BKV at 6 months in patients receiving CIP prophylaxis. This may come at the expense of increased antibiotic resistance.

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