No Routine Antimicrobial Use for Post-Transplant Asymptomatic Bacteriuria

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At 24 months follow up, no difference was found in primary outcomes in those treated for 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).

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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.

Source

  1. 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
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