Scientific Poster Session III - Original Research

Abstract

Research Question or Hypothesis: What is the preferred second line agent (dapsone or atovaquone) for the prevention of PJP in kidney transplant recipients intolerant to SMX-TMP at our center?

Study Design: Retrospective chart review evaluating first-time adult kidney transplant recipients from June 2013 - February 2022.

Methods: Patients were included if they initiated either dapsone or atovaquone as second line agents for PJP prophylaxis within 30 days of transplant. The primary endpoint was the percent of patients unable to tolerate a complete course of prophylactic therapy. Intolerability was defined as discontinuation of either agent due to reported hypersensitivity, adverse effects, or patient preference. Secondary endpoints included the incidence of PJP and readmissions due to PJP infection within one year of transplant. Data were analyzed with inferential and descriptive statistics.

Results: Six hundred sixty-six subjects were screened and 42 kidney transplant recipients were initiated on either dapsone (n=33) or atovaquone (n=9) within the first 30 days after their transplant. Discontinuation occurred in 12 patients (36%) in the dapsone group and 0 patients in the atovaquone group (p=0.032). The average time to discontinuation was 51 days. The primary reasons for discontinuation were anemia (67%), thrombocytopenia (8%), and elevated transaminases (8%). No patients in either group developed a PJP infection within the study period.

Conclusion: Atovaquone demonstrated greater tolerability compared to dapsone. Both agents were effective in preventing PJP infection within one year of kidney transplant.

Presenting Author

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