Is there a role for antimicrobial management in organ transplantation?

Purpose of review This unique review on the rationale and implementation of antimicrobial management in the solid organ transplant setting will identify strategies that can be used to improve empiric antimicrobial therapy and decrease antimicrobial use. Recent findings Most data on antimicrobial management and solid organ transplantation recipients is incorporated into ICU outcomes. Recently published guidelines for antimicrobial management programs can be tailored for this population. Strategies that are valuable to solid organ transplantation programs include postantimicrobial approval, which has shown a greater reduction in antimicrobial usage. The solid organ transplantation clinical pharmacist role can include antimicrobial management, which increases patient safety and decreases ineffective therapy. Also computerized assistance for the pharmacist has demonstrated time and cost-savings. Unit-specific antibiograms should be developed and lead to accurate empiric therapy, and the microbiology laboratory can also introduce rapid diagnostics, which have shown to improve outcomes. Lastly, a collaborative development of evidence-based guidelines can reduce antimicrobial usage reduction with resulting decrease in antimicrobial resistance. Summary Antimicrobial management can be included in solid organ transplantation practice with these strategies and benefit the programs by ensuring early appropriate antimicrobial therapy, with early discontinuation of ineffective therapy resulting in less antimicrobial resistance and improved outcomes.