Efficacy of Trimethoprim-Sulfamethoxazole Prophylaxis for Nocardia in Solid Organ Transplant Recipients (SOTRs): Systematic Review and Meta-Analysis.

A. Alsharidi,¹ A. Gonzalez,² C. Rotstein,³ A. Humar,³ D. Kumar,³ S. Husain.³

¹Medicine, Infectious Diseases, McMaster University, Hamilton, ON, Canada
²Medicine, Infectious Diseases, University of Florida, Gainesville, FL
³Multi-Organ Transplant, Transplant Infectious Diseases, University of Toronto, Toronto, ON, Canada

Meeting: 2017 American Transplant Congress

Abstract number: B104

Keywords: Prophylaxis

Session Information

Session Name: Poster Session B: Bacteria, Fungi, Parasites

Session Type: Poster Session

Date: Sunday, April 30, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Background:

There are increasing reports of breakthrough Nocardia infection in patients taking Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis post SOT. We performed a meta-analysis to evaluate the effectiveness of TMP-SMX prophylaxis to prevent Nocardia infection in SOTRs.

Methods:

We did a computerized search, with help from an expert librarian at our center, for any published articles before July 2015 using Medline (via Ovid), Embase,Cochrane CentralRegister of Controlled Trials, Cochrane Database of Systematic Reviews and PubMed (non-Medline records including epub ahead of print) databases.

Results:

Seventeen out of 414 studies were eligible for analysis, as shown below in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In the meta-analysis of 7 studies (total 2446 patients), who reported Nocardiosis in both TMP-SMX prophylaxis and non-prophylaxis recipients, we found no signification difference of the Nocardia infection in SOTRs received TMP-SMX prophylaxis as compared to recipients who were not given prophylaxis (RR 0.52; 95% CI 0.15 -1.84; I²= 33%) as shown in figure 2. Indirect analysis showed no significant difference between TMP-SMX single strength (SS) daily and TMP-SMX double strength (DS) 3-4 times weekly prophylaxis groups (p= 0.638).Conclusions:

In this meta-analysis, prophylaxis with TMP-SMX does not appear to affect the occurrence of Nocardia infection in SOTRs.

CITATION INFORMATION: Alsharidi A, Gonzalez A, Rotstein C, Humar A, Kumar D, Husain S. Efficacy of Trimethoprim-Sulfamethoxazole Prophylaxis for Nocardia in Solid Organ Transplant Recipients (SOTRs): Systematic Review and Meta-Analysis. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Alsharidi A, Gonzalez A, Rotstein C, Humar A, Kumar D, Husain S. Efficacy of Trimethoprim-Sulfamethoxazole Prophylaxis for Nocardia in Solid Organ Transplant Recipients (SOTRs): Systematic Review and Meta-Analysis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/efficacy-of-trimethoprim-sulfamethoxazole-prophylaxis-for-nocardia-in-solid-organ-transplant-recipients-sotrs-systematic-review-and-meta-analysis/. Accessed May 11, 2025.

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