Perioperative fosfomycin disodium prophylaxis against urinary tract infection in renal transplant recipients: a randomized clinical trial
| Autor: | Cristopher Kauffman-Ortega, Rodrigo Cruz-Martínez, Mariedel Trujeque-Matos, José Sifuentes-Osornio, Elia Criollo-Mora, Rodrigo Rosado-Canto, Javier Tejeda-Maldonado, Francisco Rodríguez-Covarrubias, Luis E. Morales-Buenrostro, Ernesto Maravilla-Franco, Idalia Parra-Avila, José M. Arreola-Guerra |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Bacteriuria Urinary system 030232 urology & nephrology kidney transplantation 030230 surgery urologic and male genital diseases Placebo Perioperative Care law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Fosfomycin Randomized controlled trial law Internal medicine medicine Humans AcademicSubjects/MED00340 Adverse effect Kidney transplantation Transplantation business.industry Incidence (epidemiology) Original Articles Perioperative Prognosis medicine.disease Trimethoprim Transplant Recipients Anti-Bacterial Agents Nephrology Urinary Tract Infections Female prophylaxis urinary tract infection business medicine.drug |
| Zdroj: | Nephrology Dialysis Transplantation |
| ISSN: | 1460-2385 0931-0509 0323-5947 |
| DOI: | 10.1093/ndt/gfz261 |
| Popis: | Background Symptomatic urinary tract infection (UTI) is the most common infectious complication in renal transplant recipients (RTRs). Fosfomycin (FOS) is an attractive alternative for prophylaxis because it does not interact with immunosuppressants; although 90% is excreted unchanged in the urine, it does not require adjustment for renal function for single dose prophylaxis. Methods RTRs were recruited into this randomized, double-blind, placebo-controlled trial. Participants were randomized (1:1) to receive one 4 g dose of FOS disodium intravenously 3 h (FOS group) or placebo (placebo group) before placement and removal of a urinary catheter and before removal of a double-J ureteral stent. All participants received prophylaxis with trimethoprim/sulfamethoxazole. The main outcome was a comparison of the mean number of symptomatic UTI and asymptomatic bacteriuria (AB) episodes per patient during a 7-week follow-up period. The study was registered at ClinicalTrials.gov, NTC03235947. Results Eighty-two participants were included (41 in the FOS group and 41 in placebo group). The mean number of AB or symptomatic UTI episodes per patient was lower in the FOS group [intention-to-treat (ITT) 0.29 versus 0.60, P = 0.04]. The incidence of symptomatic UTI was lower in the FOS group (ITT, 7.3% versus 36.6%, P = 0.001), and there was no difference in the incidence of AB between both groups. The incidence of adverse events was similar in both groups. Conclusions FOS addition is an effective and safe strategy to reduce the number of symptomatic UTIs during the first 7 weeks after renal transplant. |
| Databáze: | OpenAIRE |
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