Post-Transplant UTI Prophylaxis Protocol Addresses Sulfa Allergy

Using cephalexin may decrease UTI incidence and cost of care.
Using cephalexin may decrease UTI incidence and cost of care.

SAN FRANCISCO—Adding cephalexin to a post-transplant prophylaxis protocol for kidney transplant recipients with sulfa allergy may decrease the incidence of urinary tract infections (UTIs) and cost of care, according to a new study presented at the 2014 World Transplant Congress.

Timothy Horwedel, PharmD, of Washington University School of Medicine in St. Louis, Mo., and his colleagues examined the use of indefinite sulfamethoxazole-trimethoprim (SMX/TMP) and UTI rates after renal transplantation compared with universal UTI prophylaxis that included cephalexin for renal transplant recipients with sulfa allergies. The study included 1,235 patients who were received kidney transplants from 2002 to 2010.

The use of cephalexin was associated with an overall increased cost per patient ($3,965.84) compared with SMX/TMP ($2,071.99).

However, the costs were less compared with no prophylaxis ($5,774.35). The researchers pointed out that UTIs are common in renal transplant recipients but currently there are no guidelines that address standardized UTI prophylaxis. They say they hope this study will help better guide clinicians on the optimal approach to decreasing the incidence of UTI in patients with sulfa allergies.

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