Purpose: BK nephropathy is a serious complication after kidney transplantation and can ultimately lead to graft failure. Since fluoroquinolones inhibit BK DNA topoisomerase it has been suggested that ciprofloxacin prophylaxis could reduce the risk of BK virus reactivation. We sought to examine the impact of six months ciprofloxacin prophylaxis on the incidence of BK viremia and nephropathy after kidney transplantation in our center. Methods: In this retrospective cohort study we evaluated 59 adult renal allograft recipients transplanted between January 2008-December 2011 and received ciprofloxacin 250 mg daily for 6 months (Group 1). Comparison group was selected 1:1 from patients who received trimethoprim/sulfamethoxazole prophylaxis during the same period, matched for age, race, gender, donor type, induction regimen, and history of previous transplant (Group 2). Transplant biopsy and screening for BK viremia by PCR were performed at 3 months and 12 months post-transplant and when indicated for graft dysfunction. We analyzed the incidence of BK viremia and BK nephropathy during the first year after transplantation. Results: Baseline characteristics are listed in Table 1.

At 12 months, BK viremia was detected in 3 patients (5.1%) in group 1 and 3 patients (5.1%) in group 2 (p=1). BK nephropathy was diagnosed in 3 patients (5.1%) in group 1 and 1 patient (1.7%) in group 2 (p=0.49). Conclusion: The results of our study suggest that ciprofloxacin prophylaxis does not reduce the risk of BK virus reactivation evidenced by BK viremia or BK nephropathy in kidney transplant recipients. Our data does not support any role for ciprofloxacin as a part of treatment for BK virus reactivation.

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