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. 2024 Aug 16:37:13245.
doi: 10.3389/ti.2024.13245. eCollection 2024.

Antibiotic Prophylaxis in Patients Undergoing Lung Transplant: Single-Center Cohort Study

Renato Pascale  1   2 , Beatrice Tazza  2 , Armando Amicucci  1 , Elena Salvaterra  3 , Giampiero Dolci  4 , Filippo Antonacci  5 , Massimo Baiocchi  6 , Saverio Pastore  6 , Simone Ambretti  1   7 , Maddalena Peghin  8 , Pierluigi Viale  1   2 , Maddalena Giannella  1   2
Affiliations

Antibiotic Prophylaxis in Patients Undergoing Lung Transplant: Single-Center Cohort Study

Renato Pascale et al. Transpl Int. .

Abstract

Perioperative antibiotic prophylaxis (PAP) in lung transplant recipients (LuTRs) has high heterogeneity between centers. Our aim was to investigate retrospectively the approach to PAP in our center over a 20-year period (2002-2023), and its impact on early post-operative infections (EPOIs) after lung transplantation (LuT). Primary endpoint was diagnosis of EPOI, defined as any bacterial infection including donor-derived events diagnosed within 30 days from LuT. Main exposure variables were type of PAP (combination vs. monotherapy) and PAP duration. We enrolled 111 LuTRs. PAP consisted of single-agent or combination regimens in 26 (25.2%) and 85 (74.8%) LuTR. Median PAP duration was 10 days (IQR 6-13) days. Piperacillin/tazobactam was the most common agent used either as monotherapy (n = 21, 80.7%) or as combination with levofloxacin (n = 79, 92.9%). EPOIs were diagnosed in 30 (27%) patients. At multivariable analysis no advantages were found for combination regimens compared to single-agent PAP in preventing EPOI (OR: 1.57, 95% CI: 0.488-5.068, p:0.448). The impact of PAP duration on EPOIs development was investigated including duration of PAP ≤6 days as main exposure variables, without finding a significantly impact (OR:2.165, 95% CI: 0.596-7.863, p: 0.240). Our results suggest no advantages for combination regimens PAP in preventing EPOI in LuTR.

Keywords: antibiotic prophylaxis; bacterial infection; donor derived infections; idiopatic pulmonary fibrosis; lung transplant.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study flow chart.
FIGURE 2
FIGURE 2
Perioperative antibiotic prophylaxis regimens.
See this image and copyright information in PMC

References

    1. Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Goldfarb SB, et al. The Registry of the International Society for Heart and LUNG Transplantation: Thirty-Second Official Adult LUNG and Heart-Lung Transplantation Report--2015; Focus Theme: Early Graft Failure. J Heart Lung Transpl (2015) 34(10):1264–77. 10.1016/j.healun.2015.08.014 - DOI - PubMed
    1. Verleden SE, Sacreas A, Vos R, Vanaudenaerde BM, Verleden GM. Advances in Understanding Bronchiolitis Obliterans After LUNG Transplantation. Chest (2016) 150(1):219–25. 10.1016/j.chest.2016.04.014 - DOI - PubMed
    1. Aguilar-Guisado M, Givaldá J, Ussetti P, Ramos A, Morales P, Blanes M, et al. Pneumonia After LUNG Transplantation in the RESITRA Cohort: A Multicenter Prospective Study. Am J Transpl (2007) 7(8):1989–96. 10.1111/j.1600-6143.2007.01882.x - DOI - PubMed
    1. Beaume M, Köhler T, Greub G, Manuel O, Aubert JD, Baerlocher L, et al. Rapid Adaptation Drives Invasion of Airway Donor Microbiota by Pseudomonas After LUNG Transplantation. Sci Rep (2017) 7:40309. 10.1038/srep40309 - DOI - PMC - PubMed
    1. Vital D, Hofer M, Benden C, Holzmann D, Boehler A. Impact of Sinus Surgery on Pseudomonal Airway Colonization, Bronchiolitis Obliterans Syndrome and Survival in Cystic Fibrosis LUNG Transplant Recipients. Respiration (2013) 86(1):25–31. 10.1159/000339627 - DOI - PubMed

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