Prophylaxis for opportunistic infections for kidney transplantation recipients at the Royal hospital in Oman

ABSTRACT

The main objective of this study is to ensure all patients undergone kidney transplantation receives appropriate standard PCP prophylaxis soon after transplantation, unless contraindicated. A prospective study included all kidney transplantation recipients from January 2008 to August 2008. A data collection sheet was designed and reviewed in focus group meetings and modified accordingly. The subjects were followed-up during the admission for transplantation to the date of discharge. The discharge prescriptions were screened to ensure all the kidney transplantation recipients were prescribed appropriate PCP prophylaxis before discharge. All prescriptions with NO PCP prophylaxis were intervened by the clinical pharmacist. The focus group meetings suggested designing a questionnaire using likerts scale. The purpose was to highlight doctors' perception towards PCP prophylaxis for renal transplant recipients. The questionnaires were distributed to all the nephrology doctors [consultants, senior specialists and medical officers]. The data were entered in the data collection sheet and were analyzed by using simple statistical methods. Almost 80% of the prescriptions did not included [TMP/SMX] for PCP among which 20% of the prescriptions were for patients with G6PD deficiency. The clinical pharmacist's interventions resulted that all discharge prescriptions were modified and [TMP/SMX] was prescribed for patients who were legible for a PCP prophylaxis. In the absence of prophylaxis, the incidence of PCP in solid organ transplant recipients ranges from 6.8% to 22%, necessitating PCP prophylaxis for at least 6 months following transplantation. Despite the widespread knowledge on PCP prophylaxis, most of the patients were discharged with no prophylactic treatment for PCP. After pharmacist's intervention the prescriptions were edited and PCP prophylaxis was added