BACKGROUND: The use of potent immunosuppression increases the risk of infectious complications following kidney transplantation. Sulfamethoxazole-trimethoprim (SMX/TMP) is an inexpensive broad-spectrum antimicrobial agent used in our center as lifelong prophylaxis against Pneumocystis jirovecii, unless contraindicated. This study evaluated the clinical impact of SMX/TMP prophylaxis compared with no prophylaxis with SMX/TMP (NoPPx), but with alternative agents. METHODS: This was a retrospective cohort analysis of renal transplant recipients (RTR) transplanted from January 2002 through December 2010. Patients were divided into SMX/TMP group and NoPPX group, based on whether they received prophylaxis with SMX/TMP or not, and rates of sepsis were compared between groups. We also analyzed the pathogens and source implicated in these episodes, as well as the dose of SMX/TMP. Rates were compared using multivariate logistic regression. RESULTS: With a mean follow-up of 4.8 (± 2.5) years, 63 cases of sepsis occurred in 1224 patients (5.1%), and 60% of these cases had a urinary source. The risk of sepsis was significantly reduced with prophylaxis vs. NoPPx (13.3% vs. 4.3% for SMX/TMP, P < 0.001), and this association was maintained through multivariate regression. Sepsis was associated with a numerically increased risk of graft loss and death that was not significantly affected by use of SMX/TMP. CONCLUSIONS: Prophylaxis with SMX/TMP is an inexpensive way to reduce the incidence of sepsis in RTR.
BACKGROUND: The use of potent immunosuppression increases the risk of infectious complications following kidney transplantation. Sulfamethoxazole-trimethoprim (SMX/TMP) is an inexpensive broad-spectrum antimicrobial agent used in our center as lifelong prophylaxis against Pneumocystis jirovecii, unless contraindicated. This study evaluated the clinical impact of SMX/TMP prophylaxis compared with no prophylaxis with SMX/TMP (NoPPx), but with alternative agents. METHODS: This was a retrospective cohort analysis of renal transplant recipients (RTR) transplanted from January 2002 through December 2010. Patients were divided into SMX/TMP group and NoPPX group, based on whether they received prophylaxis with SMX/TMP or not, and rates of sepsis were compared between groups. We also analyzed the pathogens and source implicated in these episodes, as well as the dose of SMX/TMP. Rates were compared using multivariate logistic regression. RESULTS: With a mean follow-up of 4.8 (± 2.5) years, 63 cases of sepsis occurred in 1224 patients (5.1%), and 60% of these cases had a urinary source. The risk of sepsis was significantly reduced with prophylaxis vs. NoPPx (13.3% vs. 4.3% for SMX/TMP, P < 0.001), and this association was maintained through multivariate regression. Sepsis was associated with a numerically increased risk of graft loss and death that was not significantly affected by use of SMX/TMP. CONCLUSIONS: Prophylaxis with SMX/TMP is an inexpensive way to reduce the incidence of sepsis in RTR.
Authors: Abhijit S Naik; Vikas R Dharnidharka; Mark A Schnitzler; Daniel C Brennan; Dorry L Segev; David Axelrod; Huiling Xiao; Lauren Kucirka; Jiajing Chen; Krista L Lentine Journal: Transpl Int Date: 2015-12-09 Impact factor: 3.782
Authors: Jens Strohaeker; Victoria Aschke; Alfred Koenigsrainer; Silvio Nadalin; Robert Bachmann Journal: J Clin Med Date: 2021-12-31 Impact factor: 4.241
Authors: Alberto Mella; Filippo Mariano; Caterina Dolla; Ester Gallo; Ana Maria Manzione; Maria Cristina Di Vico; Rossana Cavallo; Francesco Giuseppe De Rosa; Cristina Costa; Luigi Biancone Journal: Biomedicines Date: 2022-03-18