Antimicrobial stewardship in solid organ transplantation—A call for action!

Abstract

This special edition on antimicrobial stewardship in solid organ transplant recipients is a culmination of efforts over several years, including the publication of the white paper in the American Journal of Transplantation. 1 Despite almost 30 years of antimicrobial stewardship initiatives, the ability to develop programs, obtain data, and improve outcomes in transplant patients are scarce. Also, most of the initiatives published and regulatory mandates are within North America. However, traditional stewardship models on antibiotic restrictions and cost savings are difficult to sell to transplant programs and implement with this complicated patient population and may not be applicable in the global setting. Often the greatest barrier is having an

Management of infectious disease syndromes in thoracic organ transplants and mechanical circulatory device recipients: a Delphi panel

“…On the other hand, clinical uncertainty and perceived patient vulnerability to infection may lead to unnecessarily prolonged antimicrobial exposure, which may cause toxicity and selection for resistant microorganisms. As such, it is crucial that transplant‐specific guidelines are developed for these patients 3,4 …”

“…As such, it is crucial that transplant-specific guidelines are developed for these patients. 3,4 Transplant-specific guidelines for infectious clinical syndromes exist and are immensely useful tools for the transplant community. 5,6 Nevertheless, for many of these clinical syndromes, the strength of recommendation is weak and supporting data are limited.…”

Challenges and Opportunities in Antimicrobial Stewardship among Hematopoietic Stem Cell Transplant and Oncology Patients

“…The implementation of ASPs has gained more global recognition with the development of guidelines and has become a requirement for accredited hospitals by the Joint Commission in the United States [ 2 , 3 ]. It has been noted that the implementation of ASPs in transplant populations, including in solid organ transplant (SOT) recipients, poses challenges, such as increased susceptibility to infections and prolonged courses of antimicrobials [ 4 , 5 ]. However, no consensus guidelines currently exist for ASP implementation in hematopoietic stem cell transplant (HSCT) patients and patients living with malignancies [ 6 , 7 ].…”