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P neumocystis jirovecii pneumonia is rare in renal transplant recipients receiving only one month of prophylaxis
Author(s) -
Anand S.,
Samaniego M.,
Kaul D.R.
Publication year - 2011
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2011.00692.x
Subject(s) - medicine , nocardia , pneumonia , pneumocystis jirovecii , transplantation , immunosuppression , trimethoprim , surgery , nocardia brasiliensis , adverse effect , nocardiosis , antibiotics , genetics , bacteria , microbiology and biotechnology , biology
Prophylaxis against P neumocystis jirovecii pneumonia ( PCP ) is recommended for at least 4–12 months after solid organ transplant. In our center, renal transplant recipients receive only 1 month of post‐transplant trimethoprim–sulfamethoxazole, which also may provide limited protection against N ocardia . We identified only 4 PCP cases and 4 N ocardia cases in 1352 patients receiving renal and renal‐pancreas transplant from 2003 to 2009 at the U niversity of M ichigan H ealth S ystem. Two PCP cases were identified <1 year after transplant, and 2 PCP cases were identified >1 year after transplant (gross attack rate 4/1352, 0.3%). Two N ocardia cases were identified <1 year after transplant, and 2 cases were identified >1 year after transplant. All identified cases received induction therapy (7 of 8 with anti‐thymocyte globulin), whereas about one‐half of all renal transplant patients received induction therapy at our institution. No patient was treated for rejection within 6 months of PCP ; 2 of 4 patients with PCP had recent cytomegalovirus infection. All patients with PCP and 3 of 4 patients with N ocardia survived. The benefits of prolonged PCP prophylaxis should be weighed against the adverse events associated with prolonged use of antimicrobials.