Background. After kidney transplantation (KT), infections represent one of the main complications. The use of appropriate antibiotics (AB) should be optimized in order to avoid the onset of resistant strains and so be able to rely on effective molecules when needed. We designed a prospective randomized multicentre clinical trial aiming to investigate safety and effectiveness of one-shot perioperative AB prophylaxis.

Methods. From December 2006 to May 2012, 205 KT were randomized to receive either a single dose of AB at the induction of anaesthesia (n: 103, group A) or multiple doses (n: 102, group B). The infectious screening consisted of culture of preservation fluid at day 0, drain liquid at post operative days (POD) 1 and 4, urine and blood at POD 1,4,8,14,30; pharynx tampon at POD 1,4,8; expectorate at POD 1,4,8; CMV, EBV and BKV viremia at POD 8 and 30. We also recorded all evidences of clinically manifest infections.

Results. Baseline demographics of the two groups were comparable. The two groups differed only with regard to the incidence of positivity of the expectorate [22 (44%) in group A vs. 14 (25%) in group B, (p=0.03)]. However, in no case these findings were associated leukocytosis, fever or any other sign of active infection.

Conclusion. The one-shot AB prophylaxis after KT is safe and comparable to the multiple doses regimen.

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