Publication: Evaluación de una estrategia de detección y tratamiento sistemático de la bacteriuria asintomática en receptores de trasplante renal: ensayo clínico prospectivo, controlado y aleatorizado
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2019-03-05
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Universidad Complutense de Madrid
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Abstract
Las infecciones del tracto urinario (ITU) constituyen la complicación infecciosa más frecuente en trasplantados renales. Estudios realizados en la década de 1970 demostraron un descenso en la tasa de pielonefritis aguda (PNA) en mujeres embarazadas cuando se aplicó una estrategia de cribado y tratamiento de la bacteriuria asintomática (BA), por lo que se consideró que esta práctica podría ser beneficiosa si se aplicaba a otros grupos de riesgo. Aunque ensayos posteriores realizados en poblaciones de alto riesgo fueron proporcionando evidencia suficiente como para desaconsejar el tratamiento de la BA, la falta de estudios de calidad en receptores de trasplante renal (TR) no ha permitido hasta la fecha establecer recomendaciones claras, por lo que continúa siendo controvertida la indicación de tratamiento en estos pacientes. Se llevó a cabo un estudio comparativo, aleatorizado, abierto y paralelo para comprobar, en la práctica clínica, la viabilidad y beneficios de la búsqueda y tratamiento antibiótico sistemático de todos los episodios de BA durante los dos primeros años postrasplante...
Urinary tract infections (UTI) are the most common infectious complication in kidney transplant (KT) recipients. Studies conducted in the1970s showed a decrease in the rate of acute pyelonephritis (APN) in pregnant women when a strategy of screening and treatment of asymptomatic bacteriuria (AB) was applied, so it was considered that this practice could be beneficial if it was applied too the risk groups. Although subsequent trials in high-risk populations have provided sufficient evidence to discourage the treatment of AB, the lack of quality studies in KT recipients has not allowed to establish clear recommendations to date, so the indication of treatment for AB in these patients remains controversial. A comparative, randomized, open and parallel study was carried out to verify, in clinical practice, the feasibility and benefits of systematic search and antibiotic treatment of all AB episodes during the first two years after transplantation...
Urinary tract infections (UTI) are the most common infectious complication in kidney transplant (KT) recipients. Studies conducted in the1970s showed a decrease in the rate of acute pyelonephritis (APN) in pregnant women when a strategy of screening and treatment of asymptomatic bacteriuria (AB) was applied, so it was considered that this practice could be beneficial if it was applied too the risk groups. Although subsequent trials in high-risk populations have provided sufficient evidence to discourage the treatment of AB, the lack of quality studies in KT recipients has not allowed to establish clear recommendations to date, so the indication of treatment for AB in these patients remains controversial. A comparative, randomized, open and parallel study was carried out to verify, in clinical practice, the feasibility and benefits of systematic search and antibiotic treatment of all AB episodes during the first two years after transplantation...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 19-12-2018