Worldwide clinical practices in perioperative antibiotic therapy for lung transplantation

Benjamin Coiffard, Eloi Prud'Homme, Sami Hraiech, Nadim Cassir, Jérôme Le Pavec, Romain Kessler, Federica Meloni, Marc Leone, Pascal Alexandre Thomas, Martine Reynaud-Gaubert, Laurent Papazian

Research output: Contribution to journalArticle

Abstract

Background: Infection is the most common cause of mortality within the first year after lung transplantation (LTx). The management of perioperative antibiotic therapy is a major issue, but little is known about worldwide practices. Methods: We sent by email a survey dealing with 5 daily clinical vignettes concerning perioperative antibiotic therapy to 180 LTx centers around the world. The invitation and a weekly reminder were sent to lung transplant specialists for a single consensus answer per center during a 3-month period. Results: We received a total of 99 responses from 24 countries, mostly from Western Europe (n = 46) and the USA (n = 34). Systematic screening for bronchial recipient colonization before LTx was mostly performed with sputum samples (72%), regardless of the underlying lung disease. In recipients without colonization, antibiotics with activity against gram-negative bacteria resistant strains (piperacillin/tazobactam, cefepime, ceftazidime, carbapenems) were reported in 72% of the centers, and antibiotics with activity against methicillin-resistant Staphylococcus aureus (mainly vancomycin) were reported in 38% of the centers. For these recipients, the duration of antibiotics reported was 7 days (33%) or less (26%) or stopped when cultures of donor and recipients were reported negatives (12%). In recipients with previous colonization, antibiotics were adapted to the susceptibility of the most resistant strain and given for at least 14 days (67%). Conclusion: Practices vary widely around the world, but resistant bacterial strains are mostly targeted even if no colonization occurs. The antibiotic duration reported was longer for colonized recipients.

Original languageEnglish
Article number109
JournalBMC Pulmonary Medicine
Volume20
Issue number1
DOIs
Publication statusPublished - Apr 29 2020

Keywords

  • Antibiotic therapy
  • Bronchial colonization
  • Lung transplantation
  • Perioperative
  • Survey

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Coiffard, B., Prud'Homme, E., Hraiech, S., Cassir, N., Le Pavec, J., Kessler, R., Meloni, F., Leone, M., Thomas, P. A., Reynaud-Gaubert, M., & Papazian, L. (2020). Worldwide clinical practices in perioperative antibiotic therapy for lung transplantation. BMC Pulmonary Medicine, 20(1), [109]. https://doi.org/10.1186/s12890-020-1151-9