Antimicrobial treatment no benefit after kidney transplant

(HealthDay)—For patients undergoing kidney transplantation (KT), systematic antimicrobial treatment of asymptomatic bacteriuria (AB) beyond the second month post-transplant is not beneficial, according to a study published online April 18 in the American Journal of Transplantation.

Julia Origüen, M.D., from the Universidad Complutense in Madrid, and colleagues randomized 112 KT recipients who developed one or more episodes of AB beyond the second month post-transplantation to either treatment (systematic antimicrobial therapy for all AB episodes up to 24 months post-transplantation; 53 patients) or control (no antimicrobial therapy; 59 patients).

The researchers found that at 24 months follow-up there were no differences in the primary outcome of occurrence of acute pyelonephritis in the intention-to-treat (7.5 and 8.4 percent in the treatment and control groups, respectively; odds ratio, 0.88; 95 percent confidence interval, 0.22 to 3.47) or per-protocol populations (3.8 and 8.0 percent, respectively; odds ratio, 0.46; 95 percent confidence interval, 0.05 to 4.34). There were no differences in any secondary outcomes (lower urinary tract infection, acute rejection, Clostridium difficile infection, colonization/infection by multidrug-resistant bacteria, graft function, and all-cause mortality).

"In conclusion, systematic screening and treatment of AB beyond the second month after transplantation provide no apparent benefit among KT recipients," the authors write.