Ciprofloxacin for Urinary Tract Infection Prophylaxis in Post-Renal Transplant Patients with Ureteral Stent Placement.

P. Kakadiya, M. Levy, G. Gupta, A. King, S. LeCorchick.

Hume-Lee Transplant Center, Virginia Commonwealth University Health, Richmond, VA

Meeting: 2017 American Transplant Congress

Abstract number: A203

Keywords: Bacterial infection, Kidney transplantation, Urinalysis

Session Information

Session Name: Poster Session A: Kidney Complications I

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Background

Urinary tract infection (UTI) is the most common infection post renal transplant. Sulfamethoxazole-trimethoprim (SMX-TMP) is often the antibiotic drug of choice due to prophylaxis coverage for both pneumocystis pneumonia and UTI. Published literature have reported a UTI rate of approximately 20% in renal transplant patients despite SMX-TMP prophylaxis. The purpose of this study is to determine whether prophylaxis for UTI using ciprofloxacin reduces the incidence of UTI compared to published rates in ureteral-stented renal transplant patients receiving SMX-TMP.

Methods

A retrospective chart review was done of patients who received a kidney transplant from January 1, 2014 to December 31, 2014. Inclusion criteria were recipients age ≥ 18 years old, with a functioning graft at 12 months post-transplant who received ciprofloxacin for ureteral stent prophylaxis. The primary outcome was the incidence of UTI at one year post-transplant. A UTI was defined as having a positive urinalysis (UA) with a positive urine culture. The secondary outcome was the incidence of fluoroquinolone-resistant organisms.

Results

The study included 91 patients of which 18 (19.8%) had a positive UA and a positive urine culture within the first year of transplant (Table 1). Eleven isolates were tested for fluoroquinolone susceptibility. Five (45.5%) of the tested isolates were fluoroquinolone-resistant. The mean time to the first UTI was 89 days.

Table 1. Incidence of UTI
	n (%)
Total No. of Positive UA	28 (30.7)
Total No. of Positive Urine Cultures	18 (19.8)
No. of Positive Urine Cultures with Positive UA	18 (19.8)

Conclusion

The incidence of UTI within one year of renal transplant using ciprofloxacin prophylaxis is similar compared to other published data using SMX-TMP. However, patients showed a high rate of fluoroquinolone-resistant UTIs. These data do not support the use of ciprofloxacin for UTI prophylaxis in renal transplant patients with ureteral stents due to similar rates of UTI and high rates of fluoroquinolone resistant infections. Continued used of SMX-TMP is justified due to similar UTI rates and the additional PCP prophylactic coverage offered.

CITATION INFORMATION: Kakadiya P, Levy M, Gupta G, King A, LeCorchick S. Ciprofloxacin for Urinary Tract Infection Prophylaxis in Post-Renal Transplant Patients with Ureteral Stent Placement. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Kakadiya P, Levy M, Gupta G, King A, LeCorchick S. Ciprofloxacin for Urinary Tract Infection Prophylaxis in Post-Renal Transplant Patients with Ureteral Stent Placement. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/ciprofloxacin-for-urinary-tract-infection-prophylaxis-in-post-renal-transplant-patients-with-ureteral-stent-placement/. Accessed November 22, 2024.

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