Kidney transplantation
Outcome
Surgical Antibiotic Prophylaxis After Renal Transplantation: Time to Reconsider

https://doi.org/10.1016/j.transproceed.2010.03.055Get rights and content

Abstract

The optimal regimen for perioperative antibiotic prophylaxis after renal transplantation remains to be determined. Worldwide, it seems there is a trend toward decreased use of prophylaxis from the first 48 hours to several days after surgery. However, bacterial strains resistant to common antibiotic agents arise even if only a single dose of a molecule is administered at any time. Inasmuch as infections currently are the primary cause of hospitalization after renal transplantation, it is desirable to not favor selection of resistant strains that may not be treated appropriately in the event of onset of infection. Therefore, antibiotic therapy, whether for therapeutic or prophylactic purposes, should be administered based exclusively on clinical evidence. Because systemic antibiotic prophylaxis is not effective against infections of the urinary tract, the objective of perioperative antibiotic prophylaxis should be to prevent infection of the surgical wound. In this case, administration of a single dose of an antibiotic agent (1-shot regimen) at the induction of anesthesia is effective and safe. For these reasons, it is urgent that new guidelines be defined for perioperative antibiotic prophylaxis. Multicenter prospective randomized trials comparing 1-shot vs multiple-dose regimens should be performed to establish the optimal regimen.

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    Citation Excerpt :

    It must be optimized to prevent and minimize the risk of these infections. Despite the existence of reports questioning the necessity of administering PAP [15–17], it seems that awareness in applying the regimens is still low. Benefits from using PAP, even if less pivotal, are still undeniable [18–22].

Giuseppe Orlando, MD, PhD, is the recipient of the Marie Curie International Outgoing Fellowship (POIF-GA-2008-221850) financed by the European Commission under the Seventh Framework Program for Research and Development.

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