%0 Journal Article
%A Coiffard, Benjamin
%A Prud'Homme, Eloi
%A Hraiech, Sami
%A Cassir, Nadim
%A Le Pavec, Jérôme
%A Kessler, Romain
%A Meloni, Federica
%A Leone, Marc
%A Thomas, Pascal Alexandre
%A Reynaud-Gaubert, Martine
%A Papazian, Laurent
%T Worldwide clinical practices in perioperative antibiotic therapy for lung transplantation.
%D 2020
%U https://hdl.handle.net/10668/25453
%X Infection is the most common cause of mortality within the first year after lung transplantation (LTx). The management of perioperative antibiotic therapy is a major issue, but little is known about worldwide practices. We sent by email a survey dealing with 5 daily clinical vignettes concerning perioperative antibiotic therapy to 180 LTx centers around the world. The invitation and a weekly reminder were sent to lung transplant specialists for a single consensus answer per center during a 3-month period. We received a total of 99 responses from 24 countries, mostly from Western Europe (n = 46) and the USA (n = 34). Systematic screening for bronchial recipient colonization before LTx was mostly performed with sputum samples (72%), regardless of the underlying lung disease. In recipients without colonization, antibiotics with activity against gram-negative bacteria resistant strains (piperacillin / tazobactam, cefepime, ceftazidime, carbapenems) were reported in 72% of the centers, and antibiotics with activity against methicillin-resistant Staphylococcus aureus (mainly vancomycin) were reported in 38% of the centers. For these recipients, the duration of antibiotics reported was 7 days (33%) or less (26%) or stopped when cultures of donor and recipients were reported negatives (12%). In recipients with previous colonization, antibiotics were adapted to the susceptibility of the most resistant strain and given for at least 14 days (67%). Practices vary widely around the world, but resistant bacterial strains are mostly targeted even if no colonization occurs. The antibiotic duration reported was longer for colonized recipients.
%K Antibiotic therapy
%K Bronchial colonization
%K Lung transplantation
%K Perioperative
%K Survey
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