TY - JOUR
T1 - One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation
T2 - A randomized, controlled clinical trial
AU - Orlando, Giuseppe
AU - Manzia, Tommaso Maria
AU - Sorge, Roberto
AU - Iaria, Giuseppe
AU - Angelico, Roberta
AU - Sforza, Daniele
AU - Toti, Luca
AU - Peloso, Andrea
AU - Patel, Timil
AU - Katari, Ravi
AU - Zambon, Joao Paulo
AU - Maida, Andrea
AU - Salerno, Maria Paola
AU - Clemente, Katia
AU - Di Cocco, Pierpaolo
AU - De Luca, Linda
AU - Tariciotti, Laura
AU - Famulari, Antonio
AU - Citterio, Franco
AU - Tisone, Giuseppe
AU - Pisani, Francesco
AU - Romagnoli, Jacopo
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.Methods We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.Results Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.Conclusion As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.
AB - Background There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.Methods We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.Results Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.Conclusion As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.
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U2 - 10.1016/j.surg.2014.06.007
DO - 10.1016/j.surg.2014.06.007
M3 - Article
C2 - 25304836
AN - SCOPUS:84919493733
SN - 0039-6060
VL - 157
SP - 104
EP - 110
JO - Surgery (United States)
JF - Surgery (United States)
IS - 1
ER -