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Efficacy of High-Dose Trimethoprim-Sulfamethoxazol Prophylaxis on Early Urinary Tract Infection After Renal Transplantation

2006; Elsevier BV; Volume: 38; Issue: 7 Linguagem: Inglês

10.1016/j.transproceed.2006.06.111

1873-2623

H.T. Khosroshahi, AmirE Mogaddam, Mohammadali M. Shoja,

Urinary Tract Infections Management

Urinary tract infection (UTI), a major cause of morbidity in renal transplant recipients, has also been found to increase mortality. The first month post–kidney transplantation is considered the critical time, with most UTI episodes during this period. The aim of this study was to compare the efficacy of various doses of trimethoprim-sulfamethoxazole (TMP/SXT) for the prophylaxis of the posttransplant UTI within the first month after kidney transplantation. In a prospective, double-blind, randomized, clinical trial, 95 kidney allograft recipients were divided into two groups: group 1 (n = 63) received low to moderate doses of TMP/SXT (either 80/400 mg or 160/800 mg, daily) and group 2 (n = 32), high doses of TMP/SXT (320/1600 mg, daily in two divided doses). These groups were comparable regarding age, gender, type of donor, and ureteral anastomosis and immunosuppressive therapy. UTI was defined as a urine culture containing more than 105 colonies. The mean age of the patients was 37 ± 12.2 years with a male/female ratio of 0.98/1. The urine culture was positive in 39 patients (41.1%). UTI was more common among female than male patients (P = .003). Escherichia coli was the most common isolated organism in both groups (53.8%). UTI was observed in about 25% of patients on the high-dose versus 49.2% of those on low- to moderate-dose prophylaxis (P < .05). In conclusion, prophylaxis with high-dose TMP/SXT (320/1600 mg, daily) is preferred for renal transplant recipients during the first month posttransplantation.