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Clinical Significance of Prophylactic Antibiotics in Renal Transplantation

Choi, Seong-Uk; Lee, Jong Hoon; Oh, Chang-Kwon; Kim, Ji Hye; Shin, Gyu Tae; Kim, Heungsoo; Kim, Se Joong; Kim, Sun Il
Department of Surgery
Despite of decreased risk of early infections, continued use of prophylactic antibiotics may be questioned. The purpose of this study was to compare retrospectively the early infection incidence in accordance with the use of perioperative prophylactic antibiotics, and to analyze the clinical significance of perioperative prophylactic antibiotics in renal transplantation.? This retrospective, observational study enrolled 174 renal allograft recipients who underwent transplantation. The recipients were divided into two groups; group A (patients who received perioperative prophylactic antibiotics) and group B (patients who did not receive antibiotics). The infectious complications within 1 month after renal transplantation were analyzed. ?Overall, bacterial infections were registered in 13 cases (7.4%) during the first postoperative month; 6 cases (3.4%) of surgical site infection, 4 (2.3%) of urinary tract infection, 2 (1.1%) of bacteremia, 1 (0.6%) of central catheter infection, and none of respiratory infection. The incidences of bacterial infection within a month post-transplantation demonstrated not significantly different between the groups (p>0.05). The major micro-organisms isolated from the infection sites after kidney transplantation, Staphylococcus aureus and Escherichia coli, had already the multi-drug resistances at the initial time of bacterial infections.?Not only the use of prophylactic antibiotics has little impact to prevent bacterial infections after kidney transplantation but also it could induce antimicrobial resistance against the antibiotics used for prophylaxis. Moreover, the increase in antibiotic resistances prior to kidney transplantation makes the prophylactic antimicrobial agents to lose their effectiveness. The guidelines for perioperative antibiotic prophylaxis should be reformulated.
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