Evidence map›Paper›PMID 40968592›Full record

Observational studyTransplant infectious disease : an official journal of the Transplantation Society

Impact of the Duration of Trimethoprim-Sulfamethoxazole Prophylaxis on the Incidence of Infection After Kidney Transplantation: A Target Trial Emulation Study Within the Swiss Transplant Cohort Study (STCS)-The QUID-PRO-QUO Study (QUIDney Transplantation and Duration of PROphylaxis With QUO-Trimoxazole).

Aline Munting, Frédérique Chammartin, Isabelle Binet, Katia Boggian, Michael Dickenmann, Marc Froissart, Christian Garzoni, Dela Golshayan, Fadi Haidar, Cédric Hirzel and 9 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Transplant infectious disease : an official journal of the Transplantation Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Aline MuntingInfectious Diseases Service,University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Frédérique ChammartinDepartment of Clinical Research, Division of Clinical Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Isabelle BinetClinic of Nephrology and Transplantation Medicine, HOCH Health Ostschweiz, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Katia BoggianDivision of Infectious Diseases, Infection Prevention and Travel Medicine, HOCH Health Ostschweiz Kantonsspital St. Gallen, University Teaching and Research Hospital, St. Gallen, Switzerland.
Michael DickenmannClinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Marc FroissartClinical Trial Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Christian GarzoniDepartment of Infectious Diseases, Inseslspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Dela GolshayanTransplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Fadi HaidarDepartment of Medicine, Division of Nephrology, University Hospital of Geneva, Geneva, Switzerland.
Cédric HirzelDepartment of Infectious Diseases, Inseslspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Kerstin HübelClinic of Nephrology, University Hospital Zurich, Zurich, Switzerland.
Uyen Huynh-DoDivision of Nephrology and Hypertension, University Hospital Bern, Bern, Switzerland.
Nina KhannaInfectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
Michael KollerClinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Nicolas MuellerDepartment of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Daniel SidlerDivision of Nephrology and Hypertension, University Hospital Bern, Bern, Switzerland.
Christian van DeldenTransplant Infectious Diseases Unit, University Hospitals Geneva and Faculty of Medicine, Geneva, Switzerland.
Oriol ManuelInfectious Diseases Service,University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Swiss Transplant Cohort Study

Funding

Moritz Strauss FoundationSwiss National Science Foundation 10001907Swiss University Hospitals
6 · The paper itself

Abstract

backgroundTrimethoprim-sulfamethoxazole prophylaxis effectively prevents opportunistic and non-opportunistic infections in kidney transplantation, but optimal duration remains uncertain. This study investigated whether extending TMP-SMX prophylaxis is associated with lower infection rates.

methodsThis target trial emulation using observational data from the Swiss Transplant Cohort Study compared short (< 7 months) versus long (≥ 7 months) TMP-SMX prophylaxis. The primary outcome was bacterial infection potentially susceptible to TMP-SMX up to 12-months post-transplant. Inverse probability weighting (IPW) adjusted for confounders including age, living donation, lymphocyte counts, use of antithymocyte globulin, acute rejection, CMV infection, and transplant center. All bacterial and opportunistic infections, kidney function, and patient and allograft survival were summarized descriptively.

resultsA total of 1700 KTRs fulfilled inclusion criteria; 1325 (78%) participants received a short prophylaxis and 375 (22%) received a long prophylaxis. Median TMP-SMX duration was 179 days in the short group and 280 days in the long group. At 12-month post-transplant, the primary outcome was observed in 120/1325 (9.1%) in the short group and 43/375 (11.5%) in the long group. IPW analysis estimated an adjusted risk difference of 2.11% (95% CI -0.47% to 5.27%). Center, rejection, and use of ATG were associated with longer TMP-SMX duration, but risk difference was similar before and after weighting. Urinary tract infection was the most common bacterial infection. Opportunistic and overall infection rates, kidney function, and patient and graft survival were similar among groups.

conclusionsIn this target trial emulation, no differences in bacterial infection rates at 12-month post-transplant was observed between short and long TMP-SMX prophylaxis.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisBacterial InfectionsKidney TransplantationOpportunistic InfectionsTrimethoprim, Sulfamethoxazole Drug CombinationAdultAgedCohort StudiesFemaleGraft RejectionGraft SurvivalHumansIncidenceMaleMiddle AgedAnti-Bacterial AgentsTrimethoprim, Sulfamethoxazole Drug Combination

Identifiers

PMID40968592
PMCPMC12519920

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.