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Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study

BACKGROUND: Beta‐lactam allergies (BLAs) are common in hospitalized patients, including transplant recipients. BLA is associated with decreased use of preferred surgical site infection (SSI) prophylaxis and increased SSIs, but this has not been studied in the transplant population. METHODS: We revie...

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Autores principales: Mowrer, Clayton, Lyden, Elizabeth, Matthews, Stephen, Abbas, Anum, Bergman, Scott, Alexander, Bryan T., Van Schooneveld, Trevor C., Stohs, Erica J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9787036/
https://www.ncbi.nlm.nih.gov/pubmed/36254522
http://dx.doi.org/10.1111/tid.13907
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author Mowrer, Clayton
Lyden, Elizabeth
Matthews, Stephen
Abbas, Anum
Bergman, Scott
Alexander, Bryan T.
Van Schooneveld, Trevor C.
Stohs, Erica J.
author_facet Mowrer, Clayton
Lyden, Elizabeth
Matthews, Stephen
Abbas, Anum
Bergman, Scott
Alexander, Bryan T.
Van Schooneveld, Trevor C.
Stohs, Erica J.
author_sort Mowrer, Clayton
collection PubMed
description BACKGROUND: Beta‐lactam allergies (BLAs) are common in hospitalized patients, including transplant recipients. BLA is associated with decreased use of preferred surgical site infection (SSI) prophylaxis and increased SSIs, but this has not been studied in the transplant population. METHODS: We reviewed adult heart, kidney, and liver transplant recipients between January 1, 2016 and December 31, 2019 to characterize reported BLA and collect SSI prophylaxis regimens at time of transplant. We compared the use of preferred SSI prophylaxis and SSI incidence based on reported BLA status. Post hoc we collected antibiotic days of therapy (DOT) (excluding pneumocystis prophylaxis) in the 30‐day period posttransplant for patients without SSI. We utilized descriptive statistics for comparisons. RESULTS: Of 691 patients included (116 heart, 400 kidney, and 175 liver transplant recipients), 118 (17%) reported BLA. Rash and hives were the two most reported BLA reactions (36% and 24%), categorized as potential T‐cell mediated and IgE mediated, respectively. Preferred SSI prophylaxis was prescribed in 13 (11%) patients with BLA and 573 (92%) without BLA (p < .001). No difference could be detected in SSI incidence between BLA and non‐BLA patients (4.2 vs. 4.3%, p = 1.0). Of 659 without SSI, 169 (25.6%) received antibiotics within 30 days of transplant; mean antibiotic DOT for BLA and non‐BLA patients were 3.5 ± 8.0 versus 2.3 ± 5.8, p = .12. CONCLUSION: BLA transplant recipients received nonpreferred SSI prophylaxis more frequently than non‐BLA recipients, but there was no difference in 30‐day SSIs between the groups. One‐fourth of solid organ transplant recipients received systemic antibiotics within 30 days of transplant. [Image: see text]
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spelling pubmed-97870362022-12-27 Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study Mowrer, Clayton Lyden, Elizabeth Matthews, Stephen Abbas, Anum Bergman, Scott Alexander, Bryan T. Van Schooneveld, Trevor C. Stohs, Erica J. Transpl Infect Dis Original Research Papers BACKGROUND: Beta‐lactam allergies (BLAs) are common in hospitalized patients, including transplant recipients. BLA is associated with decreased use of preferred surgical site infection (SSI) prophylaxis and increased SSIs, but this has not been studied in the transplant population. METHODS: We reviewed adult heart, kidney, and liver transplant recipients between January 1, 2016 and December 31, 2019 to characterize reported BLA and collect SSI prophylaxis regimens at time of transplant. We compared the use of preferred SSI prophylaxis and SSI incidence based on reported BLA status. Post hoc we collected antibiotic days of therapy (DOT) (excluding pneumocystis prophylaxis) in the 30‐day period posttransplant for patients without SSI. We utilized descriptive statistics for comparisons. RESULTS: Of 691 patients included (116 heart, 400 kidney, and 175 liver transplant recipients), 118 (17%) reported BLA. Rash and hives were the two most reported BLA reactions (36% and 24%), categorized as potential T‐cell mediated and IgE mediated, respectively. Preferred SSI prophylaxis was prescribed in 13 (11%) patients with BLA and 573 (92%) without BLA (p < .001). No difference could be detected in SSI incidence between BLA and non‐BLA patients (4.2 vs. 4.3%, p = 1.0). Of 659 without SSI, 169 (25.6%) received antibiotics within 30 days of transplant; mean antibiotic DOT for BLA and non‐BLA patients were 3.5 ± 8.0 versus 2.3 ± 5.8, p = .12. CONCLUSION: BLA transplant recipients received nonpreferred SSI prophylaxis more frequently than non‐BLA recipients, but there was no difference in 30‐day SSIs between the groups. One‐fourth of solid organ transplant recipients received systemic antibiotics within 30 days of transplant. [Image: see text] John Wiley and Sons Inc. 2022-10-18 2022-10 /pmc/articles/PMC9787036/ /pubmed/36254522 http://dx.doi.org/10.1111/tid.13907 Text en © 2022 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Mowrer, Clayton
Lyden, Elizabeth
Matthews, Stephen
Abbas, Anum
Bergman, Scott
Alexander, Bryan T.
Van Schooneveld, Trevor C.
Stohs, Erica J.
Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title_full Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title_fullStr Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title_full_unstemmed Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title_short Beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: A retrospective cohort study
title_sort beta‐lactam allergies, surgical site infections, and prophylaxis in solid organ transplant recipients at a single center: a retrospective cohort study
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9787036/
https://www.ncbi.nlm.nih.gov/pubmed/36254522
http://dx.doi.org/10.1111/tid.13907
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