No Routine Antimicrobial Use for Post-Transplant Asymptomatic Bacteriuria
At 24 months follow up, no difference was found in primary outcomes in those treated for asymptomatic bacteriuria.
HealthDay News — For patients undergoing kidney transplantation (KT), systematic antimicrobial treatment of asymptomatic bacteriuria (AB) beyond the second month post-transplant is not beneficial, according to a study published online in the American Journal of Transplantation.
Julia Origüen, MD, from the Universidad Complutense in Madrid, and colleagues randomized 112 KT recipients who developed 1 or more episodes of AB beyond the second month post-transplantation to either treatment (systematic antimicrobial therapy for all AB episodes up to 24 months post-transplantation; 53 patients) or control (no antimicrobial therapy; 59 patients).
The researchers found that at 24 months follow-up there were no differences in the primary outcome of occurrence of acute pyelonephritis in the intention-to-treat (7.5% and 8.4% in the treatment and control groups, respectively; odds ratio, 0.88; 95%confidence interval, 0.22 to 3.47) or per-protocol populations (3.8% and 8.0%, respectively; odds ratio, 0.46; 95% confidence interval, 0.05 to 4.34). There were no differences in any secondary outcomes (lower urinary tract infection, acute rejection, Clostridium difficile infection, colonization/infection by multidrug-resistant bacteria, graft function, and all-cause mortality).
"In conclusion, systematic screening and treatment of AB beyond the second month after transplantation provide no apparent benefit among KT recipients," the authors write.
- Origuen J, Lopez-Medrano F, Fernandez-Ruiz M, et al. Should asymptomatic bacteriuria be systematically treated in kidney transplant recipients? Results from a randomized controlled trial. Am J Transplant. 2016; doi: 10.1111/ajt.13829