The development and implementation of stewardship initiatives to optimize the prevention and treatment of cytomegalovirus infection in solid-organ transplant recipients
| Autor: | Robert R. Redfield, Jeannina A. Smith, Lucas T Schulz, Christopher M. Saddler, Didier A. Mandelbrot, John P. Rice, Margaret R. Jorgenson, Jillian L. Descourouez, Kerry A Goldrosen |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Epidemiology medicine.drug_class medicine.medical_treatment Congenital cytomegalovirus infection Antiviral Agents Immunocompromised Host 03 medical and health sciences 0302 clinical medicine medicine Humans Antimicrobial stewardship 030212 general & internal medicine Intensive care medicine 0303 health sciences 030306 microbiology business.industry Immunosuppression Organ Transplantation medicine.disease Transplant Recipients Cytomegalovirus infection Infectious Diseases Allograft rejection Cytomegalovirus Infections Stewardship Antiviral drug Solid organ transplantation business |
| Zdroj: | Infection Control & Hospital Epidemiology. 41:1068-1074 |
| ISSN: | 1559-6834 0899-823X |
| DOI: | 10.1017/ice.2020.203 |
| Popis: | Classical stewardship efforts have targeted immunocompetent patients; however, appropriate use of antimicrobials in the immunocompromised host has become a target of interest. Cytomegalovirus (CMV) infection is one of the most common and significant complications after solid-organ transplant (SOT). The treatment of CMV requires a dual approach of antiviral drug therapy and reduction of immunosuppression for optimal outcomes. This dual approach to CMV management increases complexity and requires individualization of therapy to balance antiviral efficacy with the risk of allograft rejection. In this review, we focus on the development and implementation of CMV stewardship initiatives, as a component of antimicrobial stewardship in the immunocompromised host, to optimize the management of prevention and treatment of CMV in SOT recipients. These initiatives have the potential not only to improve judicious use of antivirals and prevent resistance but also to improve patient and graft survival given the interconnection between CMV infection and allograft function. |
| Databáze: | OpenAIRE |
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