One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation: A randomized, controlled clinical trial

Giuseppe Orlando, Tommaso Maria Manzia, Roberto Sorge, Giuseppe Iaria, Roberta Angelico, Daniele Sforza, Luca Toti, Andrea Peloso, Timil Patel, Ravi Katari, Joao Paulo Zambon, Andrea Maida, Maria Paola Salerno, Katia Clemente, Pierpaolo Di Cocco, Linda De Luca, Laura Tariciotti, Antonio Famulari, Franco Citterio, Giuseppe TisoneFrancesco Pisani, Jacopo Romagnoli

Research output: Contribution to journalArticle

Abstract

Background There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.

Methods We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.

Results Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.

Conclusion As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.

Original languageEnglish
Pages (from-to)104-110
Number of pages7
JournalSurgery
Volume157
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

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Antibiotic Prophylaxis
Surgical Wound Infection
Kidney Transplantation
Randomized Controlled Trials
Anti-Bacterial Agents
Kidney
Urinary Catheters
Incidence
Microbial Drug Resistance
Foreign Bodies
Urinary Tract Infections
Multicenter Studies
Wounds and Injuries
Infection
Transplant Recipients

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Orlando, G., Manzia, T. M., Sorge, R., Iaria, G., Angelico, R., Sforza, D., ... Romagnoli, J. (2015). One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation: A randomized, controlled clinical trial. Surgery, 157(1), 104-110. https://doi.org/10.1016/j.surg.2014.06.007

One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation : A randomized, controlled clinical trial. / Orlando, Giuseppe; Manzia, Tommaso Maria; Sorge, Roberto; Iaria, Giuseppe; Angelico, Roberta; Sforza, Daniele; Toti, Luca; Peloso, Andrea; Patel, Timil; Katari, Ravi; Zambon, Joao Paulo; Maida, Andrea; Salerno, Maria Paola; Clemente, Katia; Di Cocco, Pierpaolo; De Luca, Linda; Tariciotti, Laura; Famulari, Antonio; Citterio, Franco; Tisone, Giuseppe; Pisani, Francesco; Romagnoli, Jacopo.

In: Surgery, Vol. 157, No. 1, 01.01.2015, p. 104-110.

Research output: Contribution to journalArticle

Orlando, G, Manzia, TM, Sorge, R, Iaria, G, Angelico, R, Sforza, D, Toti, L, Peloso, A, Patel, T, Katari, R, Zambon, JP, Maida, A, Salerno, MP, Clemente, K, Di Cocco, P, De Luca, L, Tariciotti, L, Famulari, A, Citterio, F, Tisone, G, Pisani, F & Romagnoli, J 2015, 'One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation: A randomized, controlled clinical trial', Surgery, vol. 157, no. 1, pp. 104-110. https://doi.org/10.1016/j.surg.2014.06.007
Orlando, Giuseppe ; Manzia, Tommaso Maria ; Sorge, Roberto ; Iaria, Giuseppe ; Angelico, Roberta ; Sforza, Daniele ; Toti, Luca ; Peloso, Andrea ; Patel, Timil ; Katari, Ravi ; Zambon, Joao Paulo ; Maida, Andrea ; Salerno, Maria Paola ; Clemente, Katia ; Di Cocco, Pierpaolo ; De Luca, Linda ; Tariciotti, Laura ; Famulari, Antonio ; Citterio, Franco ; Tisone, Giuseppe ; Pisani, Francesco ; Romagnoli, Jacopo. / One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation : A randomized, controlled clinical trial. In: Surgery. 2015 ; Vol. 157, No. 1. pp. 104-110.
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T1 - One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation

T2 - A randomized, controlled clinical trial

AU - Orlando, Giuseppe

AU - Manzia, Tommaso Maria

AU - Sorge, Roberto

AU - Iaria, Giuseppe

AU - Angelico, Roberta

AU - Sforza, Daniele

AU - Toti, Luca

AU - Peloso, Andrea

AU - Patel, Timil

AU - Katari, Ravi

AU - Zambon, Joao Paulo

AU - Maida, Andrea

AU - Salerno, Maria Paola

AU - Clemente, Katia

AU - Di Cocco, Pierpaolo

AU - De Luca, Linda

AU - Tariciotti, Laura

AU - Famulari, Antonio

AU - Citterio, Franco

AU - Tisone, Giuseppe

AU - Pisani, Francesco

AU - Romagnoli, Jacopo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.Methods We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.Results Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.Conclusion As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.

AB - Background There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.Methods We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.Results Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.Conclusion As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.

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