Outcomes Following Macrolide Use in Kidney Transplant Recipients

Canadian Journal of Kidney Health and Disease
Rachel JeongNgan N Lam

Abstract

Calcineurin inhibitors (CNI; cyclosporine, tacrolimus) are critical for kidney transplant immunosuppression, but have multiple potential drug interactions, such as with macrolide antibiotics. Macrolide antibiotics (clarithromycin, erythromycin, and azithromycin) are often used to treat atypical infections. Clarithromycin and erythromycin inhibit CNI metabolism and increase the risk of CNI nephrotoxicity, while azithromycin does not. To determine the frequency of CNI-macrolide co-prescriptions, the proportion who receive post-prescription monitoring, and the risk of adverse drug events in kidney transplant recipients. Retrospective cohort study. We used linked health care databases in Alberta, Canada. We included 293 adult kidney transplant recipients from 2008-2015 who were co-prescribed a CNI and macrolide. The primary outcome was a composite of all-cause hospitalization, acute kidney injury (creatinine increase ≥0.3 mg/dL or 1.5 times baseline), or death within 30 days of the macrolide prescription. We identified CNI-macrolide co-prescriptions and compared outcomes in those who received clarithromycin/erythromycin versus azithromycin. We used a linear mixed-effects model to examine the mean change in serum creatinine and esti...Continue Reading

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Citations

May 10, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Natthachat JurairattanapornJackrapong Bruminhent
Jul 30, 2020·Expert Opinion on Drug Metabolism & Toxicology·Alexandra L DegraeveLaure Elens
Dec 15, 2020·World Journal of Transplantation·Ebru Gok OguzMehmet Deniz Ayli
Oct 27, 2020·Canadian Journal of Kidney Health and Disease·Rachel JeongNgan N Lam

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Methods Mentioned

BETA
PCR
coronary artery bypass
biopsy

Software Mentioned

Stata MP

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