Assessment of Current Practices for Perioperative Antibiotic Prophylaxis in Kidney Transplantation in China: Results from a Nationwide Survey.

BACKGROUND

Current guidelines support routine perioperative antibiotic prophylaxis (PAP) to minimize surgical site infection in kidney transplantation (KT), though data regarding the current practices of PAP is lacking in China.

OBJECTIVE

To survey the routine PAP strategies in KT, and analyze main clinical considerations associated with adjusted antibiotic dosing regimens in different Chinese hospitals.

METHODS

A nationwide survey was conducted on behalf of the National Alliance of Transplant Pharmacists. An online questionnaire was created via Wen Juan Xing (http://www.wjx.cn) and sent to all pharmacists in the Alliance.

RESULTS

Twenty-three pharmacists from different teaching hospitals with Grade IIIA participated in the survey, with a response rate of 46.0%. There were wide differences in routine dosing regimens and clinical considerations. Six strategies were involved in living-donor KT and monotherapy was most often used (80.9%), while combination therapy was most common (69.6%) among the ten strategies in deceased-donor KT. Of fifteen antibiotics submitted in the survey, eight agents were prescribed with different doses and/or frequencies among different hospitals. Only 37.5% and 23.1% of the hospitals would stop PAP within 72 hours in living-donor KT and deceased-donor KT, respectively. Among 28 preset factors, four factors were considered significantly important to decide PAP regimens, and eight factors were considered significantly unimportant (P<0.05).

CONCLUSION

There was wide variability in routine dosing regimens and clinical considerations in PAP decisions in KT. Further investigations are warranted to obtain high-quality evidence and to make PAP in KT more rational.