Infection in Solid Organ Transplantation: Prophylactic Regimens, Clinical Manifestations, and Empiric Therapy
Solid organ transplantation has become an established practice for end-organ disease. Transplantation has inherent risks for infection which can be minimized by appropriate prophylactic, preemptive, and empiric antibiotic regimens. Proper vaccination and appropriate perioperative antibiotic use are of utmost importance in an immunocompromised patient. When immunosuppression is high, further prophylactic regimens against some pathogens, such as cytomegalovirus, are necessary. Empiric antibiotic therapy should be targeted to the most likely pathogens. However, certain antimicrobials may interact with immunosuppressant agents resulting in enhanced toxicity or decreasing immunosuppression. Appropriate monitoring parameters and protective measures should be taken.