Antibiotics versus no therapy in kidney transplant recipients with asymptomatic bacteriuria (BiRT): a pragmatic, multicentre, randomized, controlled trial

Abstract

(J. Coussement). y The members of the Bacteriuria in Renal Transplantation (BiRT) study group are listed in the Appendix.

Asymptomatic bacteriuria in kidney transplant recipients: to treat or not to treat—that is the question

“…The findings of Coussement et al [9] are in line with those of three previous trials [8,10,11] and with a meta-analysis based on the first two studies reported [12]. In a clinical trial conducted by Moradi et al [10] in Iran, 100 KT recipients with asymptomatic bacteriuria and with at least 1 year's follow-up after transplantation were divided into two groups, cases and controls.…”

“…In summary, the findings of Coussement et al [9], along with other studies reported to date [8,10,11], provide some evidence supporting recent guidelines advocating against systematically screening and treating asymptomatic bacteriuria in KT recipients [5,6]. However, these studies should be interpreted with caution because of important limitations.…”

“…In this issue of Clinical Microbiology and Infection, Coussement et al [9] present the findings of a multicentre, randomized, openlabel trial of KT recipients in 13 French and Belgian sites who experienced asymptomatic bacteriuria 2 months after transplantation. This significant trial, the largest to date, addressed the issue of whether antibiotics would be effective in reducing the occurrence of symptomatic UTI.…”

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2020

“…Coussement and colleagues sought to evaluate the impact of ASB treatment on the incidence of symptomatic UTI during the 1-year transplant follow-up period [ 20 ]. There was no difference in the cumulative incidence of symptomatic UTI between the antibiotic and no-therapy groups.…”

Asymptomatic Bacteriuria in Post Renal Transplant Patients: To Treat or Not?

“…In 2021, a randomized, multicenter controlled trial was published by Coussement et al [ 42 ] also to assess the efficacy of treating asymptomatic bacteriuria with systemic antibiotics to reduce the rates of development of symptomatic complications. They reported that antibiotics administration in 100 patients with kidney transplantation did not significantly reduce the rate of complications and symptomatic adverse events among these patients as compared to the other 99 patients that did not receive antibiotic therapy, as reported in their population that developed asymptomatic bacteriuria in at least two months following kidney transplantation.…”