Kidney Week

Abstract: FR-PO1158

Perioperative Antibiotics for Preventing Post-Surgical Site Infections in Solid Organ Transplant Recipients

Session Information

• Transplantation: Clinical - Post-Transplant Complications
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Chan, Samuel Shun-Kwan, Department of Nephrology, Princess Alexandra Hospital, Metro South Hospital and Health Service, Woollongabba, Queensland, Australia

Samuel Shun-Kwan Chan,

• Ng, Samantha, C/o, Spring Hill, Queensland, Australia

Samantha Ng,

• Hawley, Carmel, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Carmel Hawley,

• Pascoe, Elaine, The University of Queensland, New Farm, New South Wales, Australia

Elaine Pascoe,

• Chan, Hooi peng, General Practice, Brisbane, New South Wales, Australia

Hooi peng Chan,

• Playford, Geoffrey, Princess Alexaandra Hospital, Woolloongabba, New South Wales, Australia

Geoffrey Playford,

• Wong, Germaine, The University of Sydney, Sydney, New South Wales, Australia

Germaine Wong,

• Chapman, Jeremy R., Westmead Hospital, Westmead, New South Wales, Australia

Jeremy R. Chapman,

• Lim, Wai Hon, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

Wai Hon Lim,

• Francis, Ross Simon, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Ross Simon Francis,

• Isbel, Nicole, Princess Alexandra Hospital, Brisbane, Queensland, Australia

Nicole Isbel,

• Campbell, Scott B., Princess Alexandra Hospital, Brisbane, Queensland, Australia

Scott B. Campbell,

• Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia

David W. Johnson,

Group or Team Name

• Australasian Kidney Trials Network

Background

No consensus exists on the role of antibiotics for preventing surgical site infections (SSIs) in solid organ transplant recipients (SOTRs). Objectives: To assess the benefits and harms of prophylactic antibiotics for preventing SSIs in SOTRs.

Methods

The Cochrane Kidney and Transplant Register was searched up to 8 Dec 2018. Studies were identified through searches of CENTRAL, MEDLINE, EMBASE, conference proceedings, International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov. All randomized controlled trials (RCTs) and quasi RCTs in any language assessing prophylactic antibiotics for preventing SSIs in SOTRs at any time point after transplantation. Two authors independently determined study eligibility, assessed quality and extracted data. The primary outcome was SSI incidence. Summary effect estimates were obtained using a random-effects model and results were expressed as risk ratios (RR) and 95% confidence intervals (CI) for categorical variables, and mean differences (MD) or standardized mean differences (SMD) and 95% CI for continuous variables.

Results

This review included 9 eligible studies (803 participants). Six studies (416 participants) compared antibiotics versus no antibiotics and 3 studies (387 participants) compared extended duration antibiotics versus short duration antibiotics. Risk of bias was assessed as high for performance (9 studies), detection (9 studies), attrition (2 studies) and selective outcome reporting (1 study). Antibiotics had an uncertain effect on SSI incidence (RR 0.63, 95%CI 0.37-1.06; 6 studies, 416 participants, I²=61%, very low certainty evidence). Most RCTs occurred prior to 200 (RR 2.17, 95%CI 0.84-5.66; 1 study, 188 participants, very low certainty evidence) with only 1 RCT in the last 2 decades (RR 0.30, 95%CI 0.15-0.60; 5 studies, 228 participants, I²=33%, very low certainty evidence).

Conclusion

There is very low certainty evidence to support perioperative antibiotics for preventing SSIs in SOTRs. Further high quality, adequately powered RCTs would better inform practice.

Funding

• Other U.S. Government Support