title: One-shot versus multidose perioperative antibiotic prophylaxis after kidney transplantation: a randomized, controlled clinical trial.
abstract: BACKGROUND
  There is no consensus on the optimal perioperative antibiotic prophylaxis regimen for renal transplant recipients. Some studies have reported that irrigation of the wound at the time of closure without systemic antibiotics may suffice to minimize the risk for surgical site infection (SSI), but many centers still use long-term, multidose regimens in which antibiotics are administered until removal of foreign bodies occur, such as the urethral catheter, drain and central line.
  
  
  METHODS
  We designed a prospective, randomized, multicenter, controlled trial to compare a single dose versus a multidose regimen of systemic antibiotic prophylaxis in adult, nondiabetic, non-morbidly obese patients undergoing renal transplantation. The primary endpoint was the incidence of SSI; the assessment of other infection in the first postoperative month was the secondary endpoint.
  
  
  RESULTS
  Two hundred five patients were enrolled and randomized to receive either a single (n = 103) or multidose antibiotic regimen (n = 102) for prophylaxis. The incidences of SSI and urinary tract infection were similar in both groups.
  
  
  CONCLUSIONS
  As the dramatic increase in antibiotic resistance has mandated the implementation of global programs to optimize the use of antibiotic agents in humans, we believe that the single dose regimen is preferred, at least in nondiabetic, non-morbidly obese, adult renal transplant recipients.
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC. Electronic address: gorlando@wakehealth.edu.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Tommaso Maria
authors.initials: TM
authors.lastname: Manzia
authors.affiliation: Biometrics Laboratory, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorge
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iaria
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Angelico
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Sforza
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Toti
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Andrea
authors.initials: A
authors.lastname: Peloso
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Timil
authors.initials: T
authors.lastname: Patel
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Ravi
authors.initials: R
authors.lastname: Katari
authors.affiliation: Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Joao Paulo
authors.initials: JP
authors.lastname: Zambon
authors.affiliation: Department of Surgery, Renal Transplantation Unit, Catholic University, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Maida
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Salerno
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Clemente
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Di Cocco
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Tariciotti
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Famulari
authors.affiliation: Department of Surgery, Renal Transplantation Unit, Catholic University, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Citterio
authors.affiliation: Department of Surgery, Section of Transplantation, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
authors.affiliation: Department of Surgery, Section of Transplantation, University of L'Aquila, L'Aquila, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisani
authors.affiliation: Department of Surgery, Renal Transplantation Unit, Catholic University, Rome, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Romagnoli
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002511:Cephalosporins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins