Wenjing Hou,1,2,* Jiayu Yang,3,* Kuifen Ma,2,4 Xiangduan Liu,2,5 Hui Yang,2,6 Qing Qian,2,7 Pan Chen,2,8 Fang Zeng,2,9 Rongrong Wang,2,4 Guangzhao Wang,2,10 Aiping Wen1 

1Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 2National Alliance of Transplant Pharmacists, Zhejiang, People’s Republic of China; 3Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People’s Republic of China; 4Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 311500, People’s Republic of China; 5Department of Pharmacy, Fifth Clinical College of Henan University of Traditional Chinese Medicine (Zhengzhou People’s Hospital), Zhengzhou, 450000, People’s Republic of China; 6Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China; 7Department of Pharmacy, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, 213003, People’s Republic of China; 8Department of Pharmacy, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China; 9Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 10Department of Pharmacy, The First People’s Hospital of Yulin, Yulin, Guangxi, 537000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Aiping Wen, Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, 95# Yongan Street, Beijing, 100050, People’s Republic of China, Email wenaiping@ccmu.edu.cn

Background: Current guidelines support routine perioperative antibiotic prophylaxis (PAP) to minimize surgical site infection in kidney transplantation (KT), though data regarding the current practices of PAP is lacking in China.
Objective: To survey the routine PAP strategies in KT, and analyze main clinical considerations associated with adjusted antibiotic dosing regimens in different Chinese hospitals.
Methods: A nationwide survey was conducted on behalf of the National Alliance of Transplant Pharmacists. An online questionnaire was created via Wen Juan Xing (http://www.wjx.cn) and sent to all pharmacists in the Alliance.
Results: Twenty-three pharmacists from different teaching hospitals with Grade IIIA participated in the survey, with a response rate of 46.0%. There were wide differences in routine dosing regimens and clinical considerations. Six strategies were involved in living-donor KT and monotherapy was most often used (80.9%), while combination therapy was most common (69.6%) among the ten strategies in deceased-donor KT. Of fifteen antibiotics submitted in the survey, eight agents were prescribed with different doses and/or frequencies among different hospitals. Only 37.5% and 23.1% of the hospitals would stop PAP within 72 hours in living-donor KT and deceased-donor KT, respectively. Among 28 preset factors, four factors were considered significantly important to decide PAP regimens, and eight factors were considered significantly unimportant (P< 0.05).
Conclusion: There was wide variability in routine dosing regimens and clinical considerations in PAP decisions in KT. Further investigations are warranted to obtain high-quality evidence and to make PAP in KT more rational.

Keywords: perioperative antibiotic prophylaxis, clinical consideration, kidney transplant, nationwide survey