Antiviral Stewardship in Transplantation.

Publication date: Dec 05, 2024

Though antimicrobial stewardship programs (ASPs) are required for hospitals, the involvement of transplant recipients in programmatic interventions, protocols, and metrics has historically been limited. Though there is a growing interest in studying stewardship practices in transplant patients, optimal practices have not been clearly established. A component of ASPs, antiviral stewardship (AVS), specifically targeting cytomegalovirus (CMV), has been more recently described. Understanding AVS opportunities and interventions is particularly important for transplant recipients, given the morbidity and mortality associated with viral infections, challenging clinical syndromes, ultrasensitive molecular diagnostic assays, antiviral resistance, and costs of viral disease and medications, as well as antiviral drug toxicities. This review highlights opportunities for AVS for CMV, EBV, HSV, VZV, SARS-CoV-2, respiratory syncytial virus, and BK polyomavirus in transplant patients.

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Concepts	Keywords
Antiviral	Antimicrobial Stewardship
Cytomegalovirus	antimicrobial stewardship
Hospitals	Antiviral Agents
Programmatic	Antiviral Agents
Transplantation	antiviral stewardship
	COVID-19
	cytomegalovirus
	Humans
	Organ Transplantation
	respiratory syncytial virus
	SARS-CoV-2
	Transplant Recipients
	Virus Diseases

Semantics

Type	Source	Name
disease	MESH	morbidity
disease	MESH	viral infections
disease	MESH	syndromes
disease	MESH	Infectious Diseases
drug	DRUGBANK	Trestolone
disease	IDO	cell
disease	MESH	recurrent infections
disease	IDO	immunosuppression
disease	MESH	drug interactions
disease	MESH	infections
disease	IDO	history
disease	MESH	herpes simplex
disease	MESH	influenza
disease	MESH	immunocompromised patients
drug	DRUGBANK	Coenzyme M
pathway	KEGG	Viral replication
disease	MESH	complications
drug	DRUGBANK	Ganciclovir
drug	DRUGBANK	Foscarnet
drug	DRUGBANK	Ribavirin
drug	DRUGBANK	Cidofovir
drug	DRUGBANK	Valganciclovir
drug	DRUGBANK	Maribavir
drug	DRUGBANK	Letermovir
disease	IDO	intervention
drug	DRUGBANK	Acyclovir
disease	MESH	leukopenia
disease	MESH	neutropenia
disease	MESH	edema
disease	MESH	atrial fibrillation
drug	DRUGBANK	Voriconazole
drug	DRUGBANK	Tacrolimus
drug	DRUGBANK	Sirolimus
drug	DRUGBANK	Ciclosporin
disease	MESH	recurrence
disease	IDO	infection
disease	MESH	viremia
disease	IDO	symptom
disease	MESH	cytopenias
disease	IDO	replication
disease	IDO	algorithm
disease	IDO	assay
drug	DRUGBANK	Filgrastim
disease	MESH	graft versus host disease
disease	IDO	process
disease	MESH	upper respiratory infections
disease	MESH	respiratory failure
disease	MESH	death
disease	MESH	RSV infections
disease	MESH	anemia
disease	MESH	hemolytic anemia
disease	MESH	lymphopenia
disease	IDO	immunodeficiency
drug	DRUGBANK	Dextrose unspecified form
disease	MESH	bronchospasm
disease	MESH	pulmonary edema
disease	MESH	dyspnea
disease	MESH	COVID 19
drug	DRUGBANK	Ritonavir
drug	DRUGBANK	Oxygen
drug	DRUGBANK	Alemtuzumab
disease	MESH	encephalitis
disease	MESH	meningitis
disease	MESH	lymphoproliferative disorder
drug	DRUGBANK	Rituximab
disease	MESH	tumors
disease	MESH	EBV infection
disease	IDO	protein
disease	MESH	hemorrhagic cystitis
disease	MESH	adverse drug events
disease	IDO	antibiotic resistance
drug	DRUGBANK	Gold
disease	MESH	cytomegalovirus infection
disease	IDO	blood
drug	DRUGBANK	Mycophenolate mofetil
disease	MESH	Parainfluenza Virus Infections
disease	MESH	chronic hepatitis
disease	MESH	Hepatitis
drug	DRUGBANK	Immune Globulin Human
drug	DRUGBANK	Naproxen
disease	MESH	Leukemia
disease	MESH	Oncogenesis
drug	DRUGBANK	Levofloxacin
drug	DRUGBANK	Ciprofloxacin
disease	MESH	polyomavirus infection

Original Article

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