Journal article
Taking the challenge: A protocolized approach to optimize Pneumocystis pneumonia prophylaxis in renal transplant recipients
American Journal of Transplantation, Vol.18(2), pp.462-466
2017
Abstract
While trimethoprim‐sulfamethoxazole is considered first‐line therapy for Pneumocystis pneumonia prevention in renal transplant recipients, reported adverse drug reactions may limit use and increase reliance on costly and less effective alternatives, often aerosolized pentamidine. We report our experience implementing a protocolized approach to trimethoprim‐sulfamethoxazole adverse drug reaction assessment and rechallenge to optimize prophylaxis in this patient cohort. We retrospectively reviewed 119 patients receiving Pneumocystis pneumonia prophylaxis prior to and after protocol implementation. Forty‐two patients (35%) had 48 trimethoprim‐sulfamethoxazole adverse drug reactions documented either at baseline or during the prophylaxis period, of which 83% were non‐immune‐mediated and 17% were immune‐mediated. Significantly more patients underwent trimethoprim‐sulfamethoxazole rechallenge after protocol implementation (4/22 vs 23/27; P = .0001), with no recurrence of adverse drug reactions in 74%. In those who experienced a new or recurrent reaction (26%), all were mild and self‐limiting with only 1 recurrence of an immune‐mediated reaction. After protocol implementation, aerosolized pentamidine‐associated costs were reduced. The introduction of a standard approach to trimethoprim‐sulfamethoxazole rechallenge in the context of both prior immune and non‐immune‐mediated reactions was safe and successful in improving the uptake of first‐line Pneumocystis pneumonia prophylaxis in renal transplant recipients.
Details
- Title
- Taking the challenge: A protocolized approach to optimize Pneumocystis pneumonia prophylaxis in renal transplant recipients
- Authors/Creators
- K.F. Urbancic (Author/Creator) - Austin HealthF. Ierino (Author/Creator) - St Vincent's HealthE. Phillips (Author/Creator) - Vanderbilt University Medical CenterP.F. Mount (Author/Creator) - Austin HealthA. Mahony (Author/Creator) - Austin HealthJ.A. Trubiano (Author/Creator) - Austin Health
- Publication Details
- American Journal of Transplantation, Vol.18(2), pp.462-466
- Publisher
- Blackwell Publishing
- Identifiers
- 991005545314007891
- Copyright
- © 2017 John Wiley & Sons, Inc.
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
22 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.66 HIV
- 1.66.1769 Pneumocystis-Carinii Pneumonia
- Web Of Science research areas
- Surgery
- Transplantation
- ESI research areas
- Clinical Medicine