Clinical Significance of Prophylactic Antibiotics in Renal Transplantation

Abstract Introduction The use of new selective immunosuppressants as well as the emergence of new antimicrobial resistances raise the use of prophylactic antibiotics as a matter of controversy. The purpose of this study was to retrospectively analyze the clinical significance of prophylactic antibio...

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Bibliographic Details
Published in:Transplantation proceedings 2013-05, Vol.45 (4), p.1392-1395
Main Authors: Choi, S.U, Lee, J.H, Oh, C.-K, Shin, G.T, Kim, H, Kim, S.J, Kim, S.I
Format: Article
Language:English
Subjects:
Adult
Antibiotic Prophylaxis
Bacterial Infections - prevention & control
Female
Humans
Kidney Transplantation
Male
Middle Aged
Retrospective Studies
Surgery
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Summary:Abstract Introduction The use of new selective immunosuppressants as well as the emergence of new antimicrobial resistances raise the use of prophylactic antibiotics as a matter of controversy. The purpose of this study was to retrospectively analyze the clinical significance of prophylactic antibiotics in kidney transplantation. Methods This retrospective study included 174 renal allograft recipients who were divided into two groups: group A including patients who received perioperative prophylactic antibiotics and group B, who did not receive them. We analyzed who the incidence of infectious complications as well as the causative micro-organisms and their antimicrobial resistance within 1 month after kidney transplantation. Results Overall bacterial infections were observed during the first postoperative month in 13 cases (7.4%): 6 (3.4%) surgical site 4 (2.3%) urinary tract, 2 (1.1%) bacteremic, and 1 (0.6%) central catheter infections. There was no respiratory infection. The incidence of bacterial infection was not significantly different between the two groups. The major micro-organisms isolated after kidney transplantation, were Staphylococcus aureus and Escherichia coli; both of which had already shown multidrug resistance at the initial time of infection. Conclusion Not only did use of prophylactic antibiotics have little impact to prevent bacterial infections after kidney transplantation, but also it may induce antimicrobial resistance against the antibiotics used for prophylaxis. Moreover, the increased antibiotic resistance prior to kidney transplantation hampers the effectiveness of prophylactic antimicrobial agents. Guidelines for perioperative antibiotic prophylaxis should be therefore revised.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.10.059