Autor segons l'article: Carratalà J Cruzado J Moreso F Len Ò Tebé C Riera L Garcia D Perelló M Arcos I Polo C Bestard O Manonelles A Melilli E Oriol I Sabé N
Departament: Ciències Mèdiques Bàsiques
Autor/s de la URV: TEBÉ CORDOMÍ, CRISTIAN
Paraules clau: Urine Culture Renal Replacement Therapy Randomized Controlled Trial Pyelonephritis Prospective Study Priority Journal Outcome Assessment Opportunistic Infection Multicenter Study Mortality Minimum Inhibitory Concentration Male Kidney Transplantation Kidney Graft Kidney Failure Kidney Dysfunction Intention to Treat Analysis Human Hospitalization Graft Rejection Graft Failure Fosfomycin Follow Up Female Extended Spectrum Beta Lactamase disk diffusion Cystitis Controlled Study Clinical Article Blood Analysis Asymptomatic bacteriuria Article Antibiotic Therapy Antibiotic Sensitivity Antibiotic Resistance Amoxicillin Plus Clavulanic Acid Adult
Resum: © The Author(s) 2019. Background. Whether antibiotic treatment of asymptomatic bacteriuria (AB) can prevent acute graft pyelonephritis (AGP) in kidney transplant (KT) recipients has not been elucidated. Methods. In this multicenter, open-label, nonblinded, prospective, noninferiority, randomized controlled trial, we compared antibiotic treatment with no treatment for AB in KT recipients in the first year after transplantation when urinary catheters had been removed. The primary endpoint was the occurrence of AGP. Secondary endpoints included bacteremic AGP, cystitis, susceptibility of urine isolates, graft rejection, graft function, graft loss, opportunistic infections, need for hospitalization, and mortality. Results. We enrolled 205 KT recipients between 2013 and 2015. AB occurred in 41 (42.3%) and 46 (50.5%) patients in the treatment and no treatment groups, respectively. There were no differences in the primary endpoint in the intention-to-treat population (12.2% [5 of 41] in the treatment group vs 8.7% [4 of 46] in the no treatment group; risk ratio, 1.40; 95% confidence interval, 0.40-4.87) or the per-protocol population (13.8% [4 of 29] in the treatment group vs 6.7% [3 of 45] in the no treatment group; risk ratio, 2.07, 95% confidence interval, 0.50-8.58). No differences were found in secondary endpoints, except for antibiotic susceptibility. Fosfomycin (P = .030), amoxicillin-clavulanic (P < .001) resistance, and extended-spectrum ß-lactamase production (P = .044) were more common in KT recipients receiving antibiotic treatment for AB. Conclusions. Antibiotic treatment of AB was not useful to prevent AGP in KT recipients and may increase antibiotic resistance. However, our findings should be regarded with caution, due to the small sample size analyzed.
Àrees temàtiques: Oncology Neurology (Clinical) Microbiology Infectious Diseases Immunology Clinical Neurology
Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
Adreça de correu electrònic de l'autor: cristian.tebe@urv.cat
Identificador de l'autor: 0000-0003-2320-1385
ISSN: 23288957
Data d'alta del registre: 2020-07-24
Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
Referència a l'article segons font original: OPEN FORUM INFECTIOUS DISEASES. (ISSN/ISBN: 23288957). 6(6): OFZ243
Referència de l'ítem segons les normes APA: Sabé N, Oriol I, Melilli E, Manonelles A, Bestard O, Polo C, Arcos I, Perelló M, Garcia D, Riera L, Tebé C, Len Ò, Moreso F, Cruzado J, Carratalà J (2019). Antibiotic treatment versus no treatment for asymptomatic bacteriuria in kidney transplant recipients: A multicenter randomized trial. OPEN FORUM INFECTIOUS DISEASES, 6(6), -. DOI: 10.1093/ofid/ofz243
URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
Entitat: Universitat Rovira i Virgili
Any de publicació de la revista: 2019
Tipus de publicació: Journal Publications
Repositori URV