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

In a prospective randomized trial, 40 stage IV breast cancer patients under going 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 dev eloped FL (after 10/108 courses); in group ii, seven of 22 patients (7/98 c ourses) (P = NS). Median hospitalization duration and costs were not differ ent. RhG-CSF was 6.6 times more expensive per course than CAB. In conclusio n, prophylactic CAB has similar efficacy to rhG-CSF in this setting, and is more cost-effective.