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Antimicrobial Drug Prophylaxis: Challenges and Controversies

  • Gaurav Trikha
  • Marcio Nucci
  • John R. Wingard
  • Amar SafdarEmail author
Chapter

Abstract

Prevention of infection is important in the susceptible patients undergoing transplantation. Accurate diagnosis continues to be a challenge, and response to treatment is often suboptimal, mainly due to immune defects that cannot be corrected during the course of an infection episode. Antimicrobial drugs are the cornerstone for prevention of opportunistic and other routinely encountered infections in patients undergoing solid organ and hematopoietic stem cell allograft transplantation. However, there are many controversies associated with antimicrobial prophylaxis. In general, antimicrobial prophylaxis is beneficial during periods when the infection risk is highest including the early postoperative period in patients undergoing visceral allograft surgery and those with acute allograft rejection; in HSCT recipients with pre-engraftment neutropenia and those with graft-versus-host disease, to name a few. In a number of other situations, a clear benefit from such innervation is not certain. In this chapter, we present a comprehensive discussion on challenges and controversies associated with antimicrobial prophylaxis in HSCT and SOT recipients.

Keywords

Transplant Prophylaxis Infection Viral Bacterial Fungal Prevention 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Gaurav Trikha
    • 1
    • 2
  • Marcio Nucci
    • 3
    • 4
  • John R. Wingard
    • 5
  • Amar Safdar
    • 6
    Email author
  1. 1.Division of Infectious DiseasesUniversity of Florida College of MedicineGainesvilleUSA
  2. 2.University of Florida Health Shands Hospital, Division of Hematology/Oncology, Department of MedicineGainesvilleUSA
  3. 3.University Hospital, Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
  4. 4.Hospital Universitário Clementino Fraga Filho, Department of Internal Medicine – HematologyRio de JaneiroBrazil
  5. 5.University of Florida, Division of Hematology/Oncology, Department of MedicineGainesvilleUSA
  6. 6.Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of MedicineEl PasoUSA

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