Prophylactic wound antibiotics for combined kidney and pancreas transplants.
For combined kidney and pancreas transplant recipients infectious complications remain a major source of morbidity. With as many antibiotic protocols as transplant centers, the exact type and duration for prophylactic wound antibiotics remains undefined. A retrospective review of our series of 40 combined kidney and pancreas transplants was performed using a single 1 g dose of cefazolin preoperatively along with cefazolin bladder and intra-abdominal irrigation. Two patients developed superficial wound infections for a rate of 5% (2/37). The deep wound infection rate was 11% (4/37), and all followed either a bladder anastomotic leak or the initial development of transplant pancreatitis. Our overall rate of 16% is very comparable with other series of combined kidney and pancreas transplant recipients. To help eliminate the potential development of superinfections and resistant organisms, a single dose of antibiotics appears to be as effective for wound prophylaxis in these patients when compared to multiple-antibiotic and multiple-day regiments. A randomized prospective study of prophylactic antibiotics in combined kidney and pancreas transplants is needed.
Barone
G W
GW
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Hudec
W A
WA
Sailors
D M
DM
Ketel
B L
BL
D000328:Adult; D002437:Cefazolin / Q000008:administration & dosage*; D002511:Cephalosporins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation; D011292:Premedication; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D007507:Therapeutic Irrigation
D002511:Cephalosporins; D002437:Cefazolin