DALLE JH, AUVRIGNON A, VASSAL G, LEVERGER G; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 477.

Jeanne de Flandre Hosp, Lille, France

A 15 year-old boy was treated for a 2nd osteosarcoma (first at 12y, treated by 10 methotrexate high-dose MTX-HD 12g/m[2]/courses). The 7 first courses of MTX-HD of current treatment were followed by normal elimination of drug monitored by MTX kinetic. HD MTX was associated with alkaline hydratation and leucovorine rescue from H20 to MTX serum level less than 0.15 micro-mol/l. At day 6 of the 8th MTX-HD, he received ciprofloxacin (500 mg x 2/d) for acute sinusitis. At d7, he presented delay of MTX elimination (serum level was 320 micro-mol/l, N<15) and at d8, he developed severe cutaneous toxicity, renal failure (creatinine serum level: 323 mmol/l, N<60), hepatic injury ( STGO: 830 UI/l, N<30; STGP: 1344 UI/l, N<50) and hematological toxicity. Despite increase of leucovorine rescue, MTX serum level was normalized after 12 days. A 12 year-old girl was treated for sternal osteosarcoma. She had cutaneous infection by Pseudomonas aeroginosa and she received ciprofloxacin (500 mg x 2/d). At d2, a first course of HD-MTX (12g/m[2]) was made. Patient presented delay of MTX elimination (serum MTX level were 25; 5.3 and 2,84 micro-mol/l at H24, H48, H72; N<15; 1.5 and 0.15 respectively) associated with cutaneous toxicity and renal failure (creatinine level: 96 mmol/l). MTX serum level was normal after 7 days despite increase of leucovorine rescue. After several weeks and test-dose, HD-MTX (12 g/m[2]) was administered again and kinetic elimination of MTX was normal. In those 2 cases, patients presented until or after episode reported here a normal kinetic of MTX elimination. The alone other drug they both received in same time of MTX was ciprofloxacin. The mechanism of MTX-ciprofloxacin interaction may be bind of serum protein or renal elimination as reported between MTX and salicylic acid.KEYWORDS: Ciprofloxacin; Interaction; Methotrexate

Publication Types:

• Meeting Abstracts

Keywords:

• Ciprofloxacin
• Creatinine
• Drug Interactions
• Female
• Glomerular Filtration Rate
• Humans
• Kidney
• Kidney Failure
• Kidney Function Tests
• Kinetics
• Male
• Methotrexate
• Osteosarcoma
• methods
• organization & administration

Other ID:

• GWAIDS0010699

UI: 102248197

From Meeting Abstracts