Trial reportClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2021
Antibiotics versus no therapy in kidney transplant recipients with asymptomatic bacteriuria (BiRT): a pragmatic, multicentre, randomized, controlled trial.
Trial report in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Treatment of Asymptomatic Bacteriuria after Kidney Transplantation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2023Pooled it
- [Do we need to treat asymptomatic bacteriuria in immunocompromised patients? : A rapid review].Urologie (Heidelberg, Germany) · 2023Pooled it
- Emerging therapies and diagnostic innovations for multidrug-resistant infections in kidney allograft recipients: Challenges and future directions.World journal of nephrology · 2026Review
- Heterogeneity in the perioperative management of asymptomatic bacteriuria across urological surgery: an international survey by the EAU-YAU Working Group on Infectious Diseases.World journal of urology · 2026Article
- Charting new territory: outpatient stewardship in immunocompromised patients (first of a two-part series).Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Early warning for acute pyelonephritis with sepsis: risk prediction model for patients without renal medullary necrosis lesions.Frontiers in medicine · 2026Article
- Clinical Impact of Treating Versus Not Treating Asymptomatic Bacteriuria/Candiduria in the First Two Months After Kidney Transplantation.Antibiotics (Basel, Switzerland) · 2025Article
- Effectiveness and Safety of Antibiotics in Kidney Transplant Recipients With Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Open forum infectious diseases · 2025Article
- Clinical Urinary Tract Infections in Kidney Transplant Recipients With Initially Asymptomatic Bacteriuria: A Single-Center Retrospective Cohort Study.Kidney medicine · 2025Article
- Phage therapy as a revitalized weapon for treating clinical diseases.Microbiome research reports · 2025Review
- A five-year retrospective study focused on urinary tract infections in kidney transplant recipients in the current era of immunosuppression.Frontiers in medicine · 2025Article
- Initial empirical antibiotic therapy in kidney transplant recipients with pyelonephritis: A global survey of current practice and opinions across 19 countries on six continents.Transplant infectious disease : an official journal of the Transplantation Society · 2024Article
- Maxillofacial Infections: A 5-Year Assessment of the Epidemiology and Etiology in an Iranian Population.Journal of maxillofacial and oral surgery · 2024Article
- Nitrofurantoin as an Add-On to Conventional Prophylaxis for the Treatment of Urinary Tract Infections in Kidney Recipients: A Prospective Cohort Study.Journal of clinical medicine · 2024Article
- Therapeutic Myths in Solid Organ Transplantation Infectious Diseases.Open forum infectious diseases · 2024Article
- Systematic Review and Meta-Analysis Provide no Guidance on Management of Asymptomatic Bacteriuria within the First Year after Kidney Transplantation.Antibiotics (Basel, Switzerland) · 2024Review
- "Electronic Phenotyping" Antimicrobials to Facilitate Outpatient Stewardship for Asymptomatic Bacteriuria and Urinary Tract Infection in Renal Transplant.Open forum infectious diseases · 2024Article
- Acidic Urine pH and Clinical Outcome of Lower Urinary Tract Infection in Kidney Transplant Recipients Treated with Ciprofloxacin and Fosfomycin.Antibiotics (Basel, Switzerland) · 2024Article
- Bring it on again: antimicrobial stewardship in transplant infectious diseases: updates and new challenges.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Monocyte-derived dendritic cells can be detected in urine of kidney transplant recipients with pathogenic asymptomatic bacteriuria.Frontiers in transplantation · 2024Article
Corrections and comments
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Authors and funding
18 authors at 16 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMany transplant physicians screen for and treat asymptomatic bacteriuria (ASB) during post-kidney-transplant surveillance. We investigated whether antibiotics are effective in reducing the occurrence of symptomatic urinary tract infection (UTI) in kidney transplant recipients with ASB.
methodsWe performed this multicentre, randomized, open-label trial in kidney transplant recipients who had ASB and were ≥2 months post-transplantation. We randomly assigned participants to receive antibiotics or no therapy. The primary outcome was the incidence of symptomatic UTI over the subsequent 12 months.
resultsOne hundred and ninety-nine kidney transplant recipients with ASB were randomly assigned to antibiotics (100 participants) or no therapy (99 participants). There was no significant difference in the occurrence of symptomatic UTI between the antibiotic and no-therapy groups (27%, 27/100 versus 31%, 31/99; univariate Cox model: hazard ratio 0.83, 95%CI: 0.50-1.40; log-rank test: p 0.49). Over the 1-year study period, antibiotic use was five times higher in the antibiotic group than in the no-therapy group (30 antibiotic days/participant, interquartile range 20-41, versus 6, interquartile range 0-15, p < 0.001). Overall, 155/199 participants (78%) had at least one further episode of bacteriuria during the follow-up. Compared with the participant's baseline episode of ASB, the second episode of bacteriuria was more frequently caused by bacteria resistant to clinically relevant antibiotics (ciprofloxacin, cotrimoxazole, third-generation cephalosporin) in the antibiotic group than in the no-therapy group (18%, 13/72 versus 4%, 3/83, p 0.003).
conclusionsApplying a screen-and-treat strategy for ASB does not reduce the occurrence of symptomatic UTI in kidney transplant recipients who are more than 2 months post-transplantation. Furthermore, this strategy increases antibiotic use and promotes the emergence of resistant organisms.
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