Objectives: BK polyomavirus (BKV) infection is a significant cause of renal graft loss. Fluoroquinolones can inhibit BKV replication in vitro and small retrospective studies have shown it to be an effective prophylactic agent against BK viremia. We prospectively observed the effect of ciprofloxacin prophylaxis on the BKV infection in renal transplant recipients.

Materials and Methods: From January 2013 to December 2014, 54 kidney transplant recipients (39 cases from donation after brain death, 15 cases from donation after circulatory death) received ciprofloxacin (250mg twice daily) for 90 days (Group 1). The rate of BKV infection was compared to the results of another prospective study conducted in our center in which 90 kidney transplant recipients were included (Group 2).

Results: At 1 year, Group 1 had a significantly lower rate of BK viruria than Group 2 (24.1% vs. 45.6%, P = 0.013). Group 1 had numerical lower rate of viremia (9.3% vs. 22.2%, P = 0.068) and BKV-associated nephropathy (1.9% vs. 5.6%, P = 0.41) than Group 2, but the difference did not attain statistical significance.

Conclusions: Ninety-day ciprofloxacin prophylaxis in kidney transplant recipients is easily tolerated and is seemly associated with a lower rate of BKV infection at 1 year. Randomized controlled clinical trials is warranted to determined the effect of fluoroquinolones on the development of BK viremia in kidney transplant recipients.