Fluoroquinolones and BK virus nephropathy: A myth or a reali
BK polyomavirus (BKV) is a challenging problem for the transplant nephrologist. Various strategies have been used to prevent or treat BK virus nephropathy (BKVN). These include reduction in immunosuppression, intravenous immune globulin, cidofovir, leflunomide, and the fluoroquinolone antibiotics.

All these agents have their own toxicities. Great interest was shown to use fluoroquinolones to prevent BKVN after its useful experience was reported in bone marrow transplant. Fluoroquinolones being cheap and easily available, attracted nephrologists to use it, for prevention of BKVN.

These agents have been shown in vitro studies to be effective. However, there are mixed results about their effectiveness in prevention of BKVN in clinical setting.

This review, published in the Indian Journal of Nephrology, focuses the evidence available for using fluoroquinolones in the prevention of BKVN and its usefulness. Furthermore, a way forward to use these agents or not for prevention of BKVN is also discussed.

Fluoroquinolones have been used in vitro and in vivo studies for prevention of BKVN. The review concluded that at the moment, it cannot be recommended either as prophylactic or therapeutic option. The only viable option is screening for BKV viremia and preemptive reduction in immunosuppression on detection of the virus. There is a need for an effective and less nephrotoxic drug to prevent or treat BKVN.

Read the review in detail here: http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2018;volume=28;issue=4;spage=257;epage=264;aulast=Khalil