Prophylactic effect of low-dose trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia in adult recipients of kidney transplantation: a real-world data study

Chen, Ruo-Yang; Li, Dawei; Wang, Jieying; Zhuang, Shao-Yong; Wu, Haoyu; Wu, Jiajin; Qu, Junwen; Sun, Ning; Chen, Zhong; Zhu, C. G.; Zhang, Ming; Yu, Yuetian; Yuan, Xiaodong

doi:10.1016/j.ijid.2022.10.004

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Nevertheless, it’s crucial to mention that this study solely concentrated on the initial six months after kidney transplantation, emphasizing the necessity for long-term follow-up extending beyond this six-month period. 17 …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Epidemiological Analysis of Pneumocystis Jirovecii Pneumonia Infection in Kidney Transplant Patients with Trimethoprim-Sulfamethoxazole Dose Reduction Prophylaxis Strategy

Shan,

Wang,

Qin

et al. 2024

IDR

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Epidemiological Analysis of Pneumocystis Jirovecii Pneumonia Infection in Kidney Transplant Patients with Trimethoprim-Sulfamethoxazole Dose Reduction Prophylaxis Strategy

Shan,

Wang,

Qin

et al. 2024

IDR

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“…Importantly, SOT recipients who develop non-hypersensitivity-related TMP-SMX adverse effects are able to be successfully rechallenged in 35%–100% of cases [ 68 , 78 , 79 ]. Lower TMP-SMX doses (eg, 80/400 mg 3 times weekly) have also been shown to improve long-term prophylaxis tolerability while maintaining PJP protection and should be considered prior to permanent TMP-SMX cessation [ 80–82 ]. It should also be noted that TMP-SMX alternatives carry their own tolerability concerns.…”

Section: Myth 5: Trimethoprim-sulfamethoxazole Allergy History or Int...mentioning

confidence: 99%

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

Goodlet,

McCreary,

Nailor

et al. 2024

Open Forum Infectious Diseases

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Infection management in solid organ transplant poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic “myths” may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss six therapeutic myths with particular relevance to solid organ transplant and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population.

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“…6 PJP often occurs in patients after solid organ transplantation such as kidney transplantation. 7,8 Trimethoprim-sulfamethoxazole (TMP-SMX) is the common choice of drug for PJP initial prophylaxis and has been proven effective by reducing PJP incidence from 0.6%-14% 9 to 0.4%-2.2%. 10 However, PJP is often characterized by rapid progress, difficulty in diagnosis and poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and risk factors for late‐onset pneumocystis jirovecii pneumonia in kidney transplantation recipients

Zhu,

Xie,

Fan

et al. 2024

Mycoses

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BackgroundPneumocystis jirovecii pneumonia (PJP) is a common and troublesome complication of kidney transplantation. In the era of prophylaxis, the peak incidence of PJP after kidney transplantation and specific characteristics of late‐onset PJP have always been debated.MethodsWe performed a retrospective study by analysing the data of post‐transplantation pneumonia in adult kidney transplantation recipients between March 2014 and December 2021 in The Affiliated First Hospital of University of Science and Technology of China (USTC). A total of 361 patients were included and divided into early‐onset PJP, late‐onset PJP and non‐PJP groups. The characteristics of each group and related risk factors for the late‐onset patients were investigated.ResultsSome patients developed PJP 9 months later with a second higher occurrence between month 10 and 15 after transplantation. Compared with non‐PJP, ABO‐incompatible and cytomegalovirus (CMV) viremia were significantly associated with late onset of PJP in multivariate analysis. The use of tacrolimus, CMV viremia, elevated CD8(+) T cell percent and hypoalbuminemia were risk factors for late PJP. Receiver operating characteristic curve analysis demonstrated that a combination of those factors could increase the sensitivity of prediction remarkably, with an area under the curve of 0.82, a sensitivity of 80% and a specificity of 83%.ConclusionsPJP could occur months after kidney transplantation. ABO‐incompatible transplant recipients are at high risk of PJP. In the later stages of transplantation, CMV viremia, T lymphocyte subsets percentage and serum albumin levels should be monitored in patients using tacrolimus.

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Prophylactic effect of low-dose trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia in adult recipients of kidney transplantation: a real-world data study

Cited by 9 publications

References 25 publications

Clinical Characteristics and Epidemiological Analysis of Pneumocystis Jirovecii Pneumonia Infection in Kidney Transplant Patients with Trimethoprim-Sulfamethoxazole Dose Reduction Prophylaxis Strategy

Clinical Characteristics and Epidemiological Analysis of Pneumocystis Jirovecii Pneumonia Infection in Kidney Transplant Patients with Trimethoprim-Sulfamethoxazole Dose Reduction Prophylaxis Strategy

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

Clinical characteristics and risk factors for late‐onset pneumocystis jirovecii pneumonia in kidney transplantation recipients

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