Antibiotic Prophylaxis for Melioidosis in Patients Receiving Hemodialysis in the Tropics? One Size Does Not Fit All

被引：6

作者：

Chau, Ken W. T. ^{[1
]}

Smith, Simon ^{[1
,2
]}

Kang, Katherine ^{[1
]}

Dheda, Shyam ^{[1
]}

Hanson, Josh ^{[1
,3
]}

机构：

[1] Cairns Hosp, Dept Med, Cairns, Australia

[2] James Cook Univ, Cairns, Australia

[3] Kirby Inst, Sydney, NSW, Australia

来源：

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE | 2018年 / 99卷 / 03期

关键词：

DIALYSIS PATIENTS; TRIMETHOPRIM; MANAGEMENT; INFECTION; AUSTRALIA;

D O I：

10.4269/ajtmh.18-0421

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Melioidosis has a high case fatality rate and is more common in patients with chronic kidney disease. Some authors recommended trimethoprim/sulfamethoxazole (TMP/SMX) prophylaxis for all hemodialysis (HD) patients during the wet season in melioidosis-endemic regions. Historical data were reviewed to determine if TMP/SMX prophylaxis was warranted in the HD population of Far North Queensland, Australia. Between 1997 and 2017, there were 242 culture-confirmed cases of melioidosis in the region, three (1.2%) occurred in HD patients; all survived without intensive care support. During the study period, there were 843 HD patients in the region with 3,024 cumulative patient years of risk. Even assuming 100% efficacy, it would have been necessary to prescribe TMP/SMX for 1,008 patient years to prevent one case of melioidosis. Given the significant additional cost and potentially life-threatening side effects of TMP/SMX therapy, clinicians should review the local epidemiology of melioidosis before the implementation of universal TMP/SMX prophylaxis in their HD population.

引用

页码：597 / 600

页数：4

共 20 条

[1] [Anonymous], 37 ANZDATA REG
[2] Infection with antimicrobial-resistant microorganisms in dialysis patients
Berns, JS
[J]. SEMINARS IN DIALYSIS, 2003, 16 (01) : 30 - 37
[3] Bijl AMH, 1998, CLIN EXP ALLERGY, V28, P510, DOI 10.1046/j.1365-2222.1998.00258.x
[4] Melioidosis and end-stage renal disease in tropical northern Australia
Chalmers, Rachel M. S.
Majoni, Sandawana W.
Ward, Linda
Perry, Greg J.
Jabbar, Zulfikar
Currie, Bart J.
[J]. KIDNEY INTERNATIONAL, 2014, 86 (05) : 867 - 870
[5] Melioidosis: Epidemiology, pathophysiology, and management
Cheng, AC
Currie, BJ
[J]. CLINICAL MICROBIOLOGY REVIEWS, 2005, 18 (02) : 383 - +
[6] Pill Burden, Adherence, Hyperphosphatemia, and Quality of Life in Maintenance Dialysis Patients
Chiu, Yi-Wen
Teitelbaum, Isaac
Misra, Madhukar
de Leon, Essel Marie
Adzize, Tochi
Mehrotra, Rajnish
[J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2009, 4 (06): : 1089 - 1096
[7] The Epidemiology and Clinical Spectrum of Melioidosis: 540 Cases from the 20 Year Darwin Prospective Study
Currie, Bart J.
Ward, Linda
Cheng, Allen C.
[J]. PLOS NEGLECTED TROPICAL DISEASES, 2010, 4 (11):
[8] JICK H, 1982, REV INFECT DIS, V4, P426
[9] Limmathurotsakul D, 2016, NAT MICROBIOL, V1, DOI [10.1038/NMICROBIOL.2015.8, 10.1038/nmicrobiol.2015.8]
[10] Macmorran E, 2017, EPIDEMIOL INFECT, V145, P2817, DOI [10.1017/S0950268817001716, 10.1017/s0950268817001716]

← 1 2 →