Efficacy of antimicrobials in preventing resistance in solid organ transplant recipients:A systematic review of clinical trials  

作　　者：Carlos M Ardila Pradeep K Yadalam Jaime Ramírez-Arbelaez 

机构地区：[1]Department of Basic Sciences Faculty of Dentistry,Biomedical Stomatology Research Group,Universidad de Antioquia U de A,Medellín 0057,Colombia [2]Department of Postdoctoral Program,CIFE University Center,Cuernavaca 62330,Morelos,Mexico [3]Department of Periodontics,Saveetha Dental College,Saveetha Institute of Medical and Health,SIMATS,Saveetha University,Chennai 600077,Tamil Nadu,India [4]Department of Transplantation,Hospital San Vicente Fundación,Rionegro 054047,Colombia

出　　处：《World Journal of Transplantation》2025年第1期156-164,共9页世界移植杂志（英文）

摘　　要：BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-qual

关 键 词：Antimicrobial resistance Antimicrobials ANTIVIRALS Solid organ transplant recipients INFECTIONS MICROORGANISMS CYTOMEGALOVIRUS 

分 类 号：R617[医药卫生—外科学] R587.1[医药卫生—临床医学]