Perioperative antibiotics for preventing post-surgical site infections in solid organ transplant recipients

Chan, Samuel; Ng, Samantha; Chan, Hooi P; Pascoe, Elaine M.; Playford, E. Geoffrey; Wong, Germaine; Chapman, Jeremy R.; Lim, Wai H.; Francis, Ross; Isbel, Nicole M.; Campbell, Scott; Hawley, Carmel; Johnson, David W.

doi:10.1002/14651858.cd013209

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…11,12 Recently a Cochrane systematic review highlights the uncertainty about the use of antimicrobial prophylaxis in the solid organ transplant setting. 13 If the formal antimicrobial prophylaxis should be mainly represented by a first-generation cephalosporin monotherapy or in combination therapy with vancomycin as recommended, in some instances the lack of adherence to the current guidelines might be a ponderate choice. Certainly, randomized trials are needed in order to update the current guidelines and demonstrate the efficacy (if any) of specific antimicrobial prophylaxis regimens.…”

Section: Discussionmentioning

confidence: 99%

A worldwide survey on perioperative antimicrobial prophylaxis for heart transplantation: From theory to clinical practice

Seminari

Ladini

Colaneri

et al. 2023

Transplant Infectious Dis

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Background The aim of our survey was to analyze the current attitudes toward antimicrobial prophylaxis in heart transplanting centers worldwide. Methods The survey was composed of a total of 50 questions, it consisted of four different sections as follows. The first section collected physicians’ personal data and centers’ general characteristics, second assessed the approach to patients colonized with multidrug‐resistant organisms (MDROs), while the third consisted of the infection risk related to cardiovascular devices, and antimicrobial treatment data, the last focused on donor's colonization. Results A total of 56 answers from 26 different countries were collected, mostly from Europe (n = 30) and the USA (n = 16). A first‐generation cephalosporin (58.9%) or a combination therapy with vancomycin (10.7%) were the most frequently prescribed antimicrobial prophylaxis. Roughly 30% of the centers used different antimicrobial prophylaxis,mostly including Gram negative bacteria coverage. The frequency of screening for multidrug resistant Gram‐negative bacteria was higher in Europe, where the percentage of centers providing screening for extended spectrum beta‐lactamase (46.7%) and carbapenem‐resistant Enterobacteriaceae (CRE) (53.3%) was higher than in other geographic area (p = .019; p = .013, respectively). Conclusion This survey highlights a heterogeneity of clinical practice concerning antimicrobial prophylaxis at transplant. The concern for potential Gram‐negative bacteria infection was responsible for broader antimicrobial coverage in 30% of centers.

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Section: Discussionmentioning

confidence: 99%

A worldwide survey on perioperative antimicrobial prophylaxis for heart transplantation: From theory to clinical practice

Seminari

Ladini

Colaneri

et al. 2023

Transplant Infectious Dis

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“…No consensus currently exists for optimal antibacterial prophylaxis, but the general approach is to minimise dose and duration of administration to prevent emergence of antibiotic resistance [23]. A Cochrane systematic review is currently being undertaken to evaluate the evidence for antibiotic prophylaxis in preventing postsurgical site infections in solid organ transplant recipients [24]. Where there are risk factors that may predispose the recipient to bacterial transmission from the donor, such as treated bacteraemia or urine infection, the duration of antibiotic prophylaxis is adapted to cover the appropriate organisms.…”

Section: Prophylactic Medicationsmentioning

confidence: 99%

Perioperative Care for Kidney Transplant Recipients

Hultin¹,

Hawley²,

Johnson³

et al. 2019

Perioperative Care for Organ Transplant Recipient

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Transplantation carries significant mortality benefit compared to dialysis in end-stage kidney disease. Increased perioperative risk, however, results in a higher mortality in the first 3 months post-transplantation compared to remaining on haemodialysis. Consequently, optimal perioperative management is essential. Patients presenting for kidney transplantation require rapid assessment and preparation for theatre to minimise ischaemic times and improve mortality and graft outcomes. This task is often complicated by the presence of multiple medical comorbidities. Furthermore, early complications of hypotension, delayed graft function, renovascular and ureteric surgical complications and rejection render the perioperative phase of transplant challenging for the recipient and for the transplant team. In this chapter, we outline current practices in the assessment and management of kidney transplant recipients during the perioperative period, particularly focusing on their clinical application and the evidence underpinning them.

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