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Cuero cabelludo con múltiples nódulos eritematosos, fluctuantes, con áreas alopécicas en su superficie, acompañados de abundantes pústulas. D. Cultivo de hongos, en el que se observan colonias de color blanco-amarillento. E. Preparación teñida con azul de lactofenol, en la que se observan hifas septadas con macroconidias de extremos aguzados.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Manríquez, Sergio Niklitschek" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Manríquez" ] 1 => array:2 [ "nombre" => "Sergio" "apellidos" => "Niklitschek" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X15000774?idApp=UINPBA00004N" "url" => "/0213005X/0000003300000010/v1_201512110028/S0213005X15000774/v1_201512110028/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0213005X15001470" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2015.03.024" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1332" "copyright" => "Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Enferm Infecc Microbiol Clin. 2015;33:679.e1-679.e21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 9425 "formatos" => array:3 [ "EPUB" => 16 "HTML" => 8064 "PDF" => 1345 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Consensus statement</span>" "titulo" => "Management of urinary tract infection in solid organ transplant recipients: Consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "679.e1" "paginaFinal" => "679.e21" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la infección del tracto urinario en los receptores de trasplantes de órganos sólidos: Declaración de consenso del Grupo de Estudio de Infección en receptores de trasplantes (GESITRA) de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Red Española de Investigación en Patología Infecciosa (REIPI)" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elisa Vidal, Carlos Cervera, Elisa Cordero, Carlos Armiñanzas, Jordi Carratalá, José Miguel Cisneros, M. 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Management of urinary tract infection in solid organ transplant recipients: Consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI)" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "680" "paginaFinal" => "687" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Elisa Vidal, Carlos Cervera, Elisa Cordero, Carlos Armiñanzas, Jordi Carratalá, José Miguel Cisneros, M. 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Abordaje de la infección urinaria en receptores de trasplante de órgano sólido: documento de consenso del Grupo de Estudio de la Infección en Receptores de Trasplante (GESITRA) de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Red Española para el Estudio de Patología Infecciosa (REIPI)" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The use of solid organ transplantation (SOT) has been established as accepted therapy for end-stage disease of the kidneys, liver, heart, and lungs for nearly 30 years. Intestinal and pancreas transplantation are also generally available but are provided on a more limited basis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Infections remain a major cause of morbidity and mortality in transplant recipients. Urinary tract infections (UTI) are one of the most common infections in SOT, with a high prevalence, reaching 75% in some series involving kidney recipients. Experienced SOT researchers and clinicians have developed and implemented this consensus document in support of the optimal management of these patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The target population of this document are adults receiving SOT. The intended guideline audience is physicians involved in the care of SOT recipients (including primary care physicians). Here we report a consensus with the objective of assessing the overall available evidence and to propose recommendations on the following key issues:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0020" class="elsevierStylePara elsevierViewall">Definitions.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0025" class="elsevierStylePara elsevierViewall">Epidemiology and risk factors for UTI in SOT recipients.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0030" class="elsevierStylePara elsevierViewall">Should SOT recipients receive primary prophylaxis for UTI?</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0035" class="elsevierStylePara elsevierViewall">What should be the management of asymptomatic bacteriuria in SOT recipients?</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5.</span><p id="par0040" class="elsevierStylePara elsevierViewall">What is the best empirical treatment of UTI in SOT recipients?</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6.</span><p id="par0045" class="elsevierStylePara elsevierViewall">What is the best definitive treatment of UTI in SOT recipients?</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7.</span><p id="par0050" class="elsevierStylePara elsevierViewall">How long should SOT recipients receive antibiotics for a UTI?</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8.</span><p id="par0055" class="elsevierStylePara elsevierViewall">What should be the management of UTI caused by <span class="elsevierStyleItalic">Candida</span> spp. in SOT recipients?</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9.</span><p id="par0060" class="elsevierStylePara elsevierViewall">What should be the diagnostic–therapeutic management of recurrent UTI in SOT recipients?</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10.</span><p id="par0065" class="elsevierStylePara elsevierViewall">What role does UTI play in kidney graft rejection or dysfunction?</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">11.</span><p id="par0070" class="elsevierStylePara elsevierViewall">Antimicrobial and immunosuppressant interactions.</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0075" class="elsevierStylePara elsevierViewall">We conducted a systematic review to assess the management of UTI in SOT recipients. Data for this document were identified through a search of PubMed and references from relevant articles using the search terms “transplant” and “urinary tract infection”. The search criteria included articles in English that involved human participants. We selected and revised a total of 3043 articles from 1968 to June 2014.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The evidence level based on the available literature is given for each recommendation to assess the strength of the evidence for risk and benefits of the procedure. This article was written in accordance with international recommendations on consensus statements (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) and the recommendations of the Appraisal of Guidelines for Research and Evaluation II (AGREE II). The authors met twice to discuss the consensus and establish formal recommendations. The coordinators and authors agree on the content and conclusions. The consensus statement was sent to the 96 members of GESITRA for external revision of the manuscript. The board of directors of GESITRA will designate the coordinators to update the statements within 5 years. The full version of the consensus document of this executive summary is available at Ref. <a class="elsevierStyleCrossRef" href="#bib0005">1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Definitions</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Bacteriuria</span><p id="par0085" class="elsevierStylePara elsevierViewall">Bacteriuria is defined according to the criteria proposed by the Infectious Diseases Society of America guidelines. For asymptomatic women, bacteriuria is defined as 2 consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts ≥10<span class="elsevierStyleSup">5</span> colony-forming units (cfu)/ml. A single, clean-catch voided urine specimen with 1 bacterial species isolated in a quantitative count ≥10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>cfu/ml identifies bacteriuria in men. A single catheterized urine specimen with 1 bacterial species isolated in a quantitative count ≥10<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>cfu/ml identifies bacteriuria in women or men. Asymptomatic bacteriuria (AB) is defined by the presence of bacteriuria in the absence of any symptoms of lower or upper UTI.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Cystitis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Cystitis is defined by the presence of bacteriuria and clinical manifestations such as dysuria, frequency, or urinary urgency in the absence of pyelonephritis criteria.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pyelonephritis</span><p id="par0095" class="elsevierStylePara elsevierViewall">Pyelonephritis is defined by the simultaneous presence of a urine bacteria count ≥10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>cfu/ml and/or bacteremia and fever with one or more of the following four categories: costovertebral angle pain (if native kidney involved), renal allograft tenderness (if transplanted kidney involved), chills, criteria for cystitis (bacteriuria and clinical manifestations such as dysuria, frequency, or urinary urgency).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Reinfection</span><p id="par0100" class="elsevierStylePara elsevierViewall">Reinfection is defined by a new episode of infection with the isolation of bacterium other than the one that caused the previous infection or the same bacteria with a different antibiotic sensitivity pattern.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Relapse</span><p id="par0105" class="elsevierStylePara elsevierViewall">Relapse is defined as the isolation of the same microorganism that caused the preceding infection, with the same antibiotic sensitivity pattern, in a urine culture obtained ≥2 weeks after finishing the previous treatment.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Recurrent infection</span><p id="par0110" class="elsevierStylePara elsevierViewall">Recurrent infection is commonly defined as three or more episodes of symptomatic UTIs over a 12-month period or two episodes in the previous six months.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Complicated urinary tract infection</span><p id="par0115" class="elsevierStylePara elsevierViewall">A complicated UTI is defined as an infection that is associated with structural or functional abnormalities of the genitourinary tract, or the presence of an underlying disease that increases the risk of acquiring an infection or of failing therapy.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Prostatitis</span><p id="par0120" class="elsevierStylePara elsevierViewall">Prostatitis is characterized by discomfort referred to the lower urogenital and perineal and/or ejaculatory discomfort or sexual dysfunction. Acute bacterial prostatitis is presented as fever and chills accompanied by urinary symptoms such as dysuria, frequency, and perineal pain. Chronic bacterial prostatitis has a more prolonged course, usually of at least 3 months. This is usually related to or the result of recurrent urinary infection, or may be a complication of acute prostatitis that is not properly cured, urethritis, or epididymitis. The disease can occur continuously or episodically. The symptoms are milder than in acute prostatitis and sometimes imperceptible. The most common symptoms are perineal or pelvic pain, low back pain, testicular pain, and discomfort when urinating or ejaculating.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The classification of patients with prostatitis depends on the bacteriological study of lower urinary tract considering sequential urine cultures (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Epidemiology and risk factors for UTI in SOT recipients</span><p id="par0130" class="elsevierStylePara elsevierViewall">Some risk factors have been described for the development of UTI in SOT recipients (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Recommendations</span><p id="par0140" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Should SOT recipients receive primary prophylaxis for UTI?</span><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">1.</span><p id="par0145" class="elsevierStylePara elsevierViewall">Trimethoprim/sulfamethoxazole (TMP/SMX, cotrimoxazole 160–800<span class="elsevierStyleHsp" style=""></span>mg) antibiotic prophylaxis is recommended during the first 3–6 months post-transplant because it significantly decreases AB and symptomatic UTI, and bacteremia in renal transplant recipients (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">2.</span><p id="par0150" class="elsevierStylePara elsevierViewall">Antibiotic prophylaxis is not specifically recommended for UTI in non-kidney SOT recipients.</p><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What should be the management of asymptomatic bacteriuria in SOT recipients?</span></p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">3.</span><p id="par0160" class="elsevierStylePara elsevierViewall">Screening for and treatment of AB in kidney transplant recipients (KTR) is recommended in the early postoperative period and up to one month after transplantation (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">4.</span><p id="par0165" class="elsevierStylePara elsevierViewall">There is not enough evidence to recommend continued screening for and treatment of AB in a clinically stable KTR beyond one month after transplantation (C-III). However, there is no consensus on whether AB by multidrug resistant (MDR) bacteria, mainly Gram-negative bacilli, should be treated.</p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">5.</span><p id="par0170" class="elsevierStylePara elsevierViewall">Screening for and treatment of AB is not currently recommended for other SOT recipients (D-III). In these cases, guidelines for the general population should be applied.</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">6.</span><p id="par0175" class="elsevierStylePara elsevierViewall">Treatment of asymptomatic candiduria is not currently recommended for SOT recipients. Among patients with a urinary catheter, removal of the catheter may be sufficient to eliminate candiduria without specific antifungal therapy (D-III).</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">7.</span><p id="par0180" class="elsevierStylePara elsevierViewall">Urine culture screening of patients awaiting transplantation is not routinely recommended (D-III).</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">8.</span><p id="par0185" class="elsevierStylePara elsevierViewall">Live donors should be screened and treated for bacteriuria before the organ is harvested (A-III).</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What is the best empirical treatment of UTI in SOT recipients?</span> (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>)</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">9.</span><p id="par0195" class="elsevierStylePara elsevierViewall">The treatment strategy depends on the time elapsed since transplantation and the severity of the illness (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">10.</span><p id="par0200" class="elsevierStylePara elsevierViewall">The choice of empirical antimicrobial agents should be based on local epidemiological data and the patient's history of previous resistant organisms (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">11.</span><p id="par0205" class="elsevierStylePara elsevierViewall">Antibiotic therapies prescribed in the previous months should be taken into account (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">12.</span><p id="par0210" class="elsevierStylePara elsevierViewall">Review if the patient has recurrent episodes of UTI. The incidence of resistant organisms can rise progressively with the number of episodes (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">13.</span><p id="par0215" class="elsevierStylePara elsevierViewall">Especially if resistant organisms are found, expanded antimicrobial testing should be requested from the microbiology lab to identify treatment options for completion of therapy (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">14.</span><p id="par0220" class="elsevierStylePara elsevierViewall">Consider removal or replacement of urinary tract instruments such as urethral catheters or urologic stents (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">15.</span><p id="par0225" class="elsevierStylePara elsevierViewall">Progression of upper urinary tract disease to a renal or perinephric abscess or emphysematous pyelonephritis usually requires a multidisciplinary approach to treatment, including urologist and/or interventional radiology consultation for percutaneous or surgical drainage of abscesses (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">16.</span><p id="par0230" class="elsevierStylePara elsevierViewall">Once culture susceptibility results are available, switch to the narrowest spectrum antibiotic available to complete course of therapy (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">17.</span><p id="par0235" class="elsevierStylePara elsevierViewall">Adjust the antibiotic dosage according to the patient's renal function (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">18.</span><p id="par0240" class="elsevierStylePara elsevierViewall">In the event of severe infection with sepsis, consider the option of reducing/discontinuing the immunosuppression therapy (B-III).</p><p id="par0245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What is the best definitive treatment of UTI in SOT recipients?</span></p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">19.</span><p id="par0250" class="elsevierStylePara elsevierViewall">To choose an appropriate antibiotic for the treatment of cystitis caused by <span class="elsevierStyleItalic">Enterobacteriaceae</span>, the recommendations for the general population are adapted to organ transplant patients. For hospitalized patients, we recommend using cotrimoxazole or second- or third-generation oral cephalosporin or amoxicillin–clavulanate or fosfomycin trometamol for susceptible strains (B-I). For outpatients, we recommend ciprofloxacin or fosfomycin trometamol (B-I). For the treatment of cystitis caused by extended-spectrum beta-lactamase (ESBL)-producing <span class="elsevierStyleItalic">E. coli</span>, we recommend fosfomycin trometamol (B-I). For cystitis caused by carbapenem-resistant <span class="elsevierStyleItalic">Enterobacteriaceae</span>, we recommend using either fosfomycin trometamol or aminoglycosides (gentamicin or amikacin) (B-II). Contrary to most recommendations for the general population, nitrofurantoin is not recommended as a first-line treatment of cystitis due to the potential occurrence of adverse effects in patients with SOT (D-III).</p></li><li class="elsevierStyleListItem" id="lsti0155"><span class="elsevierStyleLabel">20.</span><p id="par0255" class="elsevierStylePara elsevierViewall">For the treatment of hospitalized patients with acute pyelonephritis caused by <span class="elsevierStyleItalic">Enterobacteriaceae</span>, we recommend the use of a beta-lactam, either third-generation cephalosporins or amoxicillin–clavulanate (B-I). After discharge or in outpatients, we recommend the use of fluoroquinolones (B-I). For pyelonephritis caused by ESBL-producing <span class="elsevierStyleItalic">Enterobacteriaceae</span>, we recommend ertapenem (B-I). Monotherapy with a carbapenem is not recommended for patients with invasive infections caused by carbapenemase-producing <span class="elsevierStyleItalic">Enterobacteriaceae</span> but may be considered in cases of mild invasive infections if adequate source control is readily achieved and the isolate is susceptible (C-III). For patients in which combination therapy is indicated, a regimen with a carbapenem plus one or two fully active drugs (including colistin, an aminoglycoside, or fosfomycin) is recommended if the carbapenem minimum inhibitory concentration (MIC) is ≤8<span class="elsevierStyleHsp" style=""></span>mg/L; this applies mainly to patients with severe infections caused by KPC-producing <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> (B-II). There are not enough data to recommend including a carbapenem in combination regimens if MIC is >8<span class="elsevierStyleHsp" style=""></span>mg/L. If this is the case, carbapenems are probably useless. Particularly if MIC is >16<span class="elsevierStyleHsp" style=""></span>mg/L, we recommend including at least two fully active drugs in the combination regimen according to susceptibility testing results (drugs to be considered: colistin, aminoglycosides, and fosfomycin) (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0160"><span class="elsevierStyleLabel">21.</span><p id="par0260" class="elsevierStylePara elsevierViewall">For the treatment of cystitis caused by <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>, we recommend ciprofloxacin for susceptible strains (B-III). For pyelonephritis by <span class="elsevierStyleItalic">P. aeruginosa</span> we recommend the use, when possible, of beta-lactams active against <span class="elsevierStyleItalic">P. aeruginosa</span> in hospitalized patients and quinolones in outpatients (B-III). For the treatment of pyelonephritis by multidrug-resistant <span class="elsevierStyleItalic">P. aeruginosa</span>, we recommend colistin or amikacin with monitoring of renal function when no other options are available (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0165"><span class="elsevierStyleLabel">22.</span><p id="par0265" class="elsevierStylePara elsevierViewall">For ampicillin-susceptible enterococci strains, we recommend oral amoxicillin for the treatment of cystitis (B-III) and intravenous ampicillin for the treatment of pyelonephritis (C-III). For ampicillin-resistant <span class="elsevierStyleItalic">Enterococcus faecium</span>, we recommend glycopeptides (C-III). For vancomycin-resistant <span class="elsevierStyleItalic">Enterococcus</span> strains, the treatment should be guided by antibiogram and we recommend the use of quinolones, cotrimoxazole, fosfomycin, nitrofurantoin, and linezolid in order of preference (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0170"><span class="elsevierStyleLabel">23.</span><p id="par0270" class="elsevierStylePara elsevierViewall">For the treatment of infected cysts in patients with renal polycystic disease, we recommend the use of fluoroquinolones or TMP/SMX when possible and percutaneous drainage if necessary (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0175"><span class="elsevierStyleLabel">24.</span><p id="par0275" class="elsevierStylePara elsevierViewall">For the treatment of acute prostatitis we recommend intravenous beta-lactams until apyrexia and consolidation treatment with fluoroquinolones or TMP/SMX when possible (B-I).</p><p id="par0280" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">How long should SOT recipients receive antibiotics for a UTI?</span></p></li><li class="elsevierStyleListItem" id="lsti0180"><span class="elsevierStyleLabel">25.</span><p id="par0285" class="elsevierStylePara elsevierViewall">Kidney recipients presenting AB within the first month of transplantation should receive an oral antibiotic selected according to the susceptibility of the isolated microorganism for a period of 5–7 days (BIII). In other SOT recipients, guidelines for the general population should be applied (AII).</p></li><li class="elsevierStyleListItem" id="lsti0185"><span class="elsevierStyleLabel">26.</span><p id="par0290" class="elsevierStylePara elsevierViewall">Cystitis in SOT recipients should be treated for 5–7 days with an oral antibiotic. Early post-transplant cystitis in renal transplant recipients may require longer treatment, especially if a ureteral stent is present (BIII). Short courses of therapy (single dose or three days) have not been studied in SOT recipients (CIII).</p></li><li class="elsevierStyleListItem" id="lsti0190"><span class="elsevierStyleLabel">27.</span><p id="par0295" class="elsevierStylePara elsevierViewall">KTR with allograft pyelonephritis should undergo a 14-day course of antibiotics. However, patients with allograft pyelonephritis in the early post-transplant period presenting with sepsis should be treated for at least 14–21 days (BIII). Late uncomplicated allograft pyelonephritis occurring more than six months after kidney transplantation may be treated with antibiotic therapy for 10–14 days (BIII). At least initially, intravenous antibiotic therapy is recommended in kidney recipients with allograft pyelonephritis (AIII).</p></li><li class="elsevierStyleListItem" id="lsti0195"><span class="elsevierStyleLabel">28.</span><p id="par0300" class="elsevierStylePara elsevierViewall">In non-kidney SOT recipients with uncomplicated pyelonephritis, a 10- to 14-day course of antibiotics is recommended (BIII). At least initially, these patients should be treated with intravenous antibiotics (AIII).</p></li><li class="elsevierStyleListItem" id="lsti0200"><span class="elsevierStyleLabel">29.</span><p id="par0305" class="elsevierStylePara elsevierViewall">No data are available on short courses (7 days) of antibiotic therapy for pyelonephritis in SOT recipients. Therefore, short-term treatment is not recommended in SOT (CIII).</p></li><li class="elsevierStyleListItem" id="lsti0205"><span class="elsevierStyleLabel">30.</span><p id="par0310" class="elsevierStylePara elsevierViewall">For SOT recipients with complicated pyelonephritis, an antibiotic course of at least two weeks is recommended and should be extended until abscesses are adequately drained and patient improvement has been achieved (BIII).</p></li><li class="elsevierStyleListItem" id="lsti0210"><span class="elsevierStyleLabel">31.</span><p id="par0315" class="elsevierStylePara elsevierViewall">For SOT recipients with acute bacterial prostatitis, a 2- to 4-week course of antibiotics is recommended. However, antibiotic therapy can be continued for up to four weeks in patients with severe illness, concomitant bacteremia, and undrained abscesses (BIII).</p></li><li class="elsevierStyleListItem" id="lsti0215"><span class="elsevierStyleLabel">32.</span><p id="par0320" class="elsevierStylePara elsevierViewall">In SOT recipients with polycystic kidney disease and infected cysts, treatment of not less than 14 days is recommended and may be extended depending on patient evolution, cyst diameter, and possibility of drainage (BIII).</p><p id="par0325" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What should be the management of UTI caused by Candida spp. in SOT recipients?</span></p><p id="par0330" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What should be the initial diagnostic approach to a SOT recipient with candiduria?</span></p></li><li class="elsevierStyleListItem" id="lsti0220"><span class="elsevierStyleLabel">33.</span><p id="par0335" class="elsevierStylePara elsevierViewall">SOT recipients with candiduria should be classified according to the presence of risk factors for disseminated candidiasis, indications for obtaining a urine culture (surveillance or infection suspicion), and according to their clinical situation (asymptomatic, with urinary tract symptoms or with general manifestations of sepsis) (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0225"><span class="elsevierStyleLabel">34.</span><p id="par0340" class="elsevierStylePara elsevierViewall">Predisposing risk factors should be eliminated or controlled (antibiotic use, malnutrition, hyperglycemia) and urinary catheters should be removed or at least changed if possible. The presence of candiduria should be verified with a second, clean-voided urine culture (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0230"><span class="elsevierStyleLabel">35.</span><p id="par0345" class="elsevierStylePara elsevierViewall">Disseminated candidiasis should be considered in all hospitalized SOT with candiduria. If clinical manifestations are compatible, blood cultures, a second urine culture after removal or replacement of the urinary catheter, fundoscopy, cultures from any other significant site (vascular accesses, peritoneal fluid, etc.), and a kidney imaging study should be obtained (AII).</p></li><li class="elsevierStyleListItem" id="lsti0235"><span class="elsevierStyleLabel">36.</span><p id="par0350" class="elsevierStylePara elsevierViewall">Patients with persistent candiduria and no indwelling bladder catheter should undergo imaging of the kidneys and collecting system to exclude renal abscess, fungus balls, or other urologic abnormalities (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0240"><span class="elsevierStyleLabel">37.</span><p id="par0355" class="elsevierStylePara elsevierViewall">SOT recipients in whom <span class="elsevierStyleItalic">Candida</span> contamination of the preservation fluid is demonstrated or suspected (donors with ruptured abdominal viscus at the time of multiorgan recovery) should undergo urgent diagnostic evaluation including Doppler ultrasound, blood and urine cultures, and cultures from any other significant site (B-III).</p><p id="par0360" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Which patients should receive antifungal drugs?</span></p></li><li class="elsevierStyleListItem" id="lsti0245"><span class="elsevierStyleLabel">38.</span><p id="par0365" class="elsevierStylePara elsevierViewall">Asymptomatic candiduria in SOT patients that are not neutropenic or undergoing a urologic procedure should not be treated with antifungal therapy (D-II).</p></li><li class="elsevierStyleListItem" id="lsti0250"><span class="elsevierStyleLabel">39.</span><p id="par0370" class="elsevierStylePara elsevierViewall">Candiduria in an unstable SOT should be initially considered as a potential marker of disseminated candidiasis. Prompt effective antifungal therapy has to be provided until an alternative diagnosis is obtained (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0255"><span class="elsevierStyleLabel">40.</span><p id="par0375" class="elsevierStylePara elsevierViewall">Candida cystitis or pyelonephritis should be treated with systemic antifungals for 2–4 weeks (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0260"><span class="elsevierStyleLabel">41.</span><p id="par0380" class="elsevierStylePara elsevierViewall">Fungus balls or casts in the pelvis or urinary bladder need surgery and systemic and/or local antifungal therapy (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0265"><span class="elsevierStyleLabel">42.</span><p id="par0385" class="elsevierStylePara elsevierViewall">KTR with contamination of the preservation fluid or with a donor with digestive tract rupture should receive early effective antifungal therapy (B-II).</p><p id="par0390" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Which drug should be prescribed and for how long?</span> (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>)</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0270"><span class="elsevierStyleLabel">43.</span><p id="par0395" class="elsevierStylePara elsevierViewall">Fluconazole is the agent of choice for most patients with <span class="elsevierStyleItalic">Candida</span> UTI due to the high concentration achieved in urine (>100<span class="elsevierStyleHsp" style=""></span>μg/ml, which is 10-fold the simultaneous plasma level) (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0275"><span class="elsevierStyleLabel">44.</span><p id="par0400" class="elsevierStylePara elsevierViewall">Other antifungal agents should only be considered for patients in unstable clinical condition, allergic to fluconazole, or in whom therapy has clearly failed despite maximum fluconazole doses and optimal management of urologic abnormalities or other predisposing conditions (B-III).</p></li><li class="elsevierStyleListItem" id="lsti0280"><span class="elsevierStyleLabel">45.</span><p id="par0405" class="elsevierStylePara elsevierViewall">A single dose of parenteral amphotericin B (AMB) deoxycholate, with or without oral 5-flucytosine, reach high concentrations in urine, and may be used to treat <span class="elsevierStyleItalic">Candida</span> cystitis in patients not responding to or not treatable with fluconazole. <span class="elsevierStyleItalic">Candida</span> pyelonephritis can also be treated with AMB. However, potential kidney toxicity limits its use in the transplant population (B-I).</p></li><li class="elsevierStyleListItem" id="lsti0285"><span class="elsevierStyleLabel">46.</span><p id="par0410" class="elsevierStylePara elsevierViewall">Liposomal AMB, with or without 5-flucytosine, may be used to treat <span class="elsevierStyleItalic">Candida</span> pyelonephritis in patients not responding to or not treatable with fluconazole. However, due to the low concentration reached in urine, a relapse may occur if the collecting system is infected (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0290"><span class="elsevierStyleLabel">47.</span><p id="par0415" class="elsevierStylePara elsevierViewall">AMB deoxycholate bladder irrigation may be used in patients with symptomatic cystitis that cannot be treated with other drugs (C-II).</p></li><li class="elsevierStyleListItem" id="lsti0295"><span class="elsevierStyleLabel">48.</span><p id="par0420" class="elsevierStylePara elsevierViewall">Echinocandins are the preferred initial agents for systemic candidiasis in unstable patients, in patients who have been exposed to azoles in the previous 3 months, and in patients with renal insufficiency requiring external replacement therapy (A-I).</p></li><li class="elsevierStyleListItem" id="lsti0300"><span class="elsevierStyleLabel">49.</span><p id="par0425" class="elsevierStylePara elsevierViewall">Echinocandins achieve low concentrations in the urinary tract but may be used in patients not responding to or not treatable with fluconazole. If the collecting system is infected, relapse may occur (C-III).</p></li><li class="elsevierStyleListItem" id="lsti0305"><span class="elsevierStyleLabel">50.</span><p id="par0430" class="elsevierStylePara elsevierViewall">All symptomatic UTIs due to <span class="elsevierStyleItalic">Candida</span> species in KTR should be considered complicated and treated for at least 14 days (B-II).</p><p id="par0435" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What should be the diagnostic–therapeutic management of recurrent UTI in SOT recipients?</span></p></li><li class="elsevierStyleListItem" id="lsti0310"><span class="elsevierStyleLabel">51.</span><p id="par0440" class="elsevierStylePara elsevierViewall">The diagnostic approach in transplant patients with recurrent UTI must be meticulous in order to rule out the existence of anatomical or functional changes (A-III).</p></li><li class="elsevierStyleListItem" id="lsti0315"><span class="elsevierStyleLabel">52.</span><p id="par0445" class="elsevierStylePara elsevierViewall">If possible, treatment aimed at the sensitivity of the isolated microorganisms must be used in patients with recurrent UTI. TMP/SMX is a good option (B-III). Quinolones must be avoided as empirical therapy (D-II).</p></li><li class="elsevierStyleListItem" id="lsti0320"><span class="elsevierStyleLabel">53.</span><p id="par0450" class="elsevierStylePara elsevierViewall">Duration of antibiotic treatment for recurrent UTIs in transplant patients is not well-defined. At least a 6-week treatment period may be recommendable (B-III), although other authors suggest prolonging treatment more than three months. Indefinite treatment may be evaluated in diabetic patients, patients with a history of UTIs before or soon after transplantation and those receiving high-dose immunosuppressive treatment (equivalent to secondary prophylaxis) (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0325"><span class="elsevierStyleLabel">54.</span><p id="par0455" class="elsevierStylePara elsevierViewall">Anatomical changes related with recurrent UTI must be corrected if possible (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0330"><span class="elsevierStyleLabel">55.</span><p id="par0460" class="elsevierStylePara elsevierViewall">The use of non-antibiotic therapies, such as cranberry extract, <span class="elsevierStyleSmallCaps">l</span>-methionine, topical estrogens, or topical application of Lactobacillus, could be provided to transplant patients with recurrent UTI (C-II).</p><p id="par0465" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">What role does UTI play in kidney graft rejection or dysfunction?</span></p></li><li class="elsevierStyleListItem" id="lsti0335"><span class="elsevierStyleLabel">56.</span><p id="par0470" class="elsevierStylePara elsevierViewall">Kidney transplant patients are particularly vulnerable to infections, and this is one of the reasons for which primary prophylaxis has been established (A-I) and early aggressive treatment of symptomatic UTI is recommended (A-II).</p></li><li class="elsevierStyleListItem" id="lsti0340"><span class="elsevierStyleLabel">57.</span><p id="par0475" class="elsevierStylePara elsevierViewall">Although UTI has been associated with induction of acute rejection in kidney transplant patients (A-II), there is controversy about the final impact on the graft in terms of chronic rejection or dysfunction (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0345"><span class="elsevierStyleLabel">58.</span><p id="par0480" class="elsevierStylePara elsevierViewall">Late-onset UTIs, which were traditionally associated with a good prognosis, have also been recently related with a risk of rejection or dysfunction of the kidney graft (B-II).</p></li><li class="elsevierStyleListItem" id="lsti0350"><span class="elsevierStyleLabel">59.</span><p id="par0485" class="elsevierStylePara elsevierViewall">The association between AB and graft loss is unclear.</p><p id="par0490" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Antimicrobial and immunosuppressant interactions</span> (<a class="elsevierStyleCrossRefs" href="#tbl0030">Tables 6–11</a>)</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia><elsevierMultimedia ident="tbl0040"></elsevierMultimedia><elsevierMultimedia ident="tbl0045"></elsevierMultimedia><elsevierMultimedia ident="tbl0050"></elsevierMultimedia><elsevierMultimedia ident="tbl0055"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0355"><span class="elsevierStyleLabel">60.</span><p id="par0495" class="elsevierStylePara elsevierViewall">The treatment of UTIs in SOT recipients is more complex due to interactions between antimicrobials and immunosuppressants.</p></li><li class="elsevierStyleListItem" id="lsti0360"><span class="elsevierStyleLabel">61.</span><p id="par0500" class="elsevierStylePara elsevierViewall">The interactions may jeopardize the transplanted organ and also increase the specific adverse effects of each drug.</p></li><li class="elsevierStyleListItem" id="lsti0365"><span class="elsevierStyleLabel">62.</span><p id="par0505" class="elsevierStylePara elsevierViewall">Key measures to avoid the consequences of these interactions are to know and to prevent them by monitoring the plasma levels of these drugs, monitoring graft function and characteristic adverse effects, and avoiding contraindicated combinations (AII).</p></li></ul></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0510" class="elsevierStylePara elsevierViewall">JMC has received a conference grant from <span class="elsevierStyleGrantSponsor" id="gs0005">Astellas</span>, <span class="elsevierStyleGrantSponsor" id="gs0010">Astra-Zeneca</span>, <span class="elsevierStyleGrantSponsor" id="gs0015">MSD</span>, <span class="elsevierStyleGrantSponsor" id="gs0020">Novartis</span>, and <span class="elsevierStyleGrantSponsor" id="gs0025">Pfizer</span>. All other authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres587771" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec603522" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres587772" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec603521" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Definitions" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Bacteriuria" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Cystitis" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Pyelonephritis" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Reinfection" ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Relapse" ] 5 => array:2 [ "identificador" => "sec0045" "titulo" => "Recurrent infection" ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Complicated urinary tract infection" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Prostatitis" ] ] ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Epidemiology and risk factors for UTI in SOT recipients" ] 8 => array:2 [ "identificador" => "sec0065" "titulo" => "Recommendations" ] 9 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflict of interest" ] 10 => array:2 [ "identificador" => "xack197727" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "Reference" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec603522" "palabras" => array:5 [ 0 => "Urinary infection" 1 => "Transplantation" 2 => "Consensus" 3 => "Prophylaxis" 4 => "Treatment" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec603521" "palabras" => array:5 [ 0 => "Infección urinaria" 1 => "Trasplante" 2 => "Consenso" 3 => "Profilaxis" 4 => "Tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Urinary tract infections (UTI) are one of the most common infections in solid organ transplant (SOT) recipients. A systematic review was performed to assess the management of UTI in SOT recipients.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recommendations are provided on the management of asymptomatic bacteriuria, and prophylaxis and treatment of UTI in SOT recipients. The diagnostic–therapeutic management of recurrent UTI and the role of infection in kidney graft rejection or dysfunction are reviewed. Finally, recommendations on antimicrobials and immunosuppressant interactions are also included.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Las infecciones del tracto urinario (ITU) son muy frecuentes en los receptores de un trasplante de órgano sólido (TOS). Hemos realizado una revisión sistemática para determinar el abordaje de la ITU en receptores de TOS.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se realizan recomendaciones sobre el abordaje de la bacteriuria asintomática y sobre la profilaxis y tratamiento de las ITU en receptores de TOS. Se han revisado el abordaje diagnóstico-terapéutico de las ITU recurrentes y el papel de la ITU en el rechazo o disfunción del injerto renal. Finalmente, se incluyen recomendaciones sobre las interacciones entre antimicrobianos e inmunosupresores.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0075">Coordinators of the document. These authors contributed equally to this work.</p>" "identificador" => "fn1" ] ] "multimedia" => array:11 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Category, grade \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Definition \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Strength of recommendation</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Solid evidence of efficacy and clinical benefit \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Solid or moderately solid evidence of efficacy, but clinical benefit is limited \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Insufficient evidence of efficacy or possible benefits in terms of efficacy do not outweigh the cost or risks (toxicity and drug interactions), valid alternatives are available \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>D \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Moderately solid evidence of a lack of efficacy or poor outcome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>E \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Strong evidence of a lack of efficacy or poor outcome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Quality of evidence</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Evidence from at least 1 well-designed and performed trial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Evidence from at least 1 well-designed non-randomized clinical trial, cohort study, or a non-controlled experimental study with non-conclusive results \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Expert opinion based on clinical experience, descriptive studies, or reports from expert panels \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959789.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Classification of the recommendations of this consensus document based on the strength and quality of the evidence analyzed.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Stamey T. Pathogenesis and Treatment of Urinary Tract Infections. Baltimore: Williams & Wilkins; 1980.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Symbol \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Description \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bladder emptying 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">BE<span class="elsevierStyleInf">1</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Initial 5–10<span class="elsevierStyleHsp" style=""></span>ml of urine stream \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bladder emptying 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">BE<span class="elsevierStyleInf">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sample midstream urinary \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Expressed prostatic secretions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">EPS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Secretions obtained from transrectal prostate by digital massage \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bladder emptying 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">BE<span class="elsevierStyleInf">3</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">First 5–10<span class="elsevierStyleHsp" style=""></span>ml of urine stream immediately after prostatic massage \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959782.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Definitive diagnosis of bacterial prostatitis requires that the number of colonies in the BE<span class="elsevierStyleInf">3</span> sample exceeds those in the BE<span class="elsevierStyleInf">1</span> sample, preferably by more than 10 times. However, the prostate of many patients with chronic prostatitis contains only small amounts of bacteria. In these patients, a prostatic secretions culture is particularly useful. Microscopic examination of the EPS is useful to identify leukocytes and “oval fat bodies” – large lipid-laden macrophages characteristic of prostatic inflammatory response.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Sequential urine cultures for anatomical location within the lower urinary tract.<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Female gender \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate mofetil \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Antithymocyte globulin \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Need for immediate post-transplant dialysis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ureteral stent placement >30 days \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Deceased-donor kidneys \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of episodes of acute rejection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Reflux kidney disease prior to transplantation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Length of hospitalization \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Length of urinary catheterization \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of episodes of acute rejection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Post-transplant urinary obstructions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Increase in immunosuppression \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959787.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Risk factors for urinary tract infections in solid organ transplantation.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">In all cases, once culture susceptibility results are available, complete therapy with the most narrow-spectrum antibiotic available.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical presentation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Absence of risk factors for multidrug-resistant (MDR) organisms \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Presence of risk factors for MDR organisms<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cystitis<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fosfomycin or amoxicillin/clavulanate or second/third generation oral cephalosporins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fosfomycin \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">If recurrence is suspected, consider potential infection for MDR organisms \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapies</span>: ertapenem, pivmecillinam if available \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapy</span>: TMP/SMX or ciprofloxacin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Acute uncomplicated pyelonephritis<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ceftriaxone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ertapenem or piperacillin-tazobactam \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapy</span>: amoxicillin/clavulanate or aztreonam (if beta-lactam allergy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapies</span>: aztreonam<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>vancomycin (if beta-lactam allergy) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Severe sepsis/septic shock \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Meropenem<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>vancomycin (if risk factors for enterococcal infection)<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>amikacin (if risk factors for <span class="elsevierStyleItalic">P. aeruginosa</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Meropenem<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>vancomycin/linezolid (if risk factors for enterococcal infection)<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>amikacin (if risk factors for <span class="elsevierStyleItalic">P. aeruginosa</span>)If potential infection by extensively-drug resistant (XDR) <span class="elsevierStyleItalic">P. aeruginosa</span> or carbapenem-resistant <span class="elsevierStyleItalic">Enterobacteriaceae</span> or MDR <span class="elsevierStyleItalic">A. baumannii</span>, consider expert consultation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapies</span>: aztreonam<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>vancomycin<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>amikacin (if risk factors for <span class="elsevierStyleItalic">P. aeruginosa</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Alternative therapies</span>: aztreonam/colistin<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>vancomycin/linezolid (if risk factors for enterococcal infection)<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>amikacin (if risk factors for <span class="elsevierStyleItalic">P. aeruginosa</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959785.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Dysuria, urgency, frequency, suprapubic pain without fever, and presence of a urine bacteria count >10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>cfu/ml.</p>" ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Fever, chills, flank/allograft pain, and presence of a urine bacteria count >10<span class="elsevierStyleSup">5</span><span class="elsevierStyleHsp" style=""></span>cfu/ml.</p>" ] 2 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Prior hospitalization (within 3 months), previous antibiotic therapy (within 1 month), previous colonization by MDR organisms, reoperation, nosocomial infection, post-transplant hemodialysis, and nephrostomy.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Empirical treatment of urinary tract infections in solid organ transplant recipients.</p>" ] ] 4 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Agent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Indications \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dose \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Comments \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug of choice for <span class="elsevierStyleItalic">Candida</span> cystitis and pyelonephritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Loading dose 12<span class="elsevierStyleHsp" style=""></span>mg/kg, followed by 6<span class="elsevierStyleHsp" style=""></span>mg/kg/d IV or PO (≥400<span class="elsevierStyleHsp" style=""></span>mg/d for symptomatic candiduria) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatotoxicity in patients with liver insufficiency \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Antifungal prophylaxis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not recommended in patients with renal replacement therapy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Preemptive therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Adjust dose if renal failure and systemic candidiasis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Targeted therapy for systemic candidiasis caused by susceptible strains in stable patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug interactions: warfarin, coumadin, oral contraceptives, benzodiazepines, cyclosporine, rifampicin, tacrolimus and others. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">d-AMB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Very rarely needed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Parenteral 0.3–1<span class="elsevierStyleHsp" style=""></span>mg/kg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Renal insufficiency \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Symptomatic cystitis or pyelonephritis in patients not responding to or not treatable with fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Continuous or intermittent bladder irrigation: 50<span class="elsevierStyleHsp" style=""></span>mg in 1<span class="elsevierStyleHsp" style=""></span>L (50<span class="elsevierStyleHsp" style=""></span>μg/ml) 1-7d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bladder irritation. Cumbersome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug interactions: cisplatin, pentamidine, aminoglycosides, cyclosporine, corticoids and others. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Candins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Initial drugs of choice for systemic candidiasis in unstable patients, in patients who have been exposed to azoles in the previous 3 months and in patients with renal insufficiency requiring external replacement therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anidulafungin 200<span class="elsevierStyleHsp" style=""></span>mg/d loading dose, followed by 100<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Preferred if recent azole exposure, patients in septic shock or with external renal devices \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Candida</span> pyelonephritis in patients not responding to or not treatable with fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Micafungin 100<span class="elsevierStyleHsp" style=""></span>mg/d IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Low urine concentration. Relapse may occur if the collecting system is the source of the candidemia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Caspofungin 70<span class="elsevierStyleHsp" style=""></span>mg loading dose, followed by 50<span class="elsevierStyleHsp" style=""></span>mg/d IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug interactions: Anidulafungin (none), Micafungin (sirolimus, nifedipine, itraconazole), Caspofungin (cyclosporine, tacrolimus, efavirenz, nevirapine, rifampicin, dexamethasone, phenytoin, carbamazepine) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L-AMB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Candida</span> pyelonephritis in patients not responding to or not treatable with fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3<span class="elsevierStyleHsp" style=""></span>mg/kg/d IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Low urine and kidney concentration. Relapse may occur \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug interactions: digoxin, aminoglycosides, cyclosporine and others. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Voriconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Candida</span> pyelonephritis in patients not responding to or not treatable with fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>mg/kg/d two loading doses, followed by 3<span class="elsevierStyleHsp" style=""></span>mg/kg/12<span class="elsevierStyleHsp" style=""></span>h IV or PO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Low urine concentration. Relapse may occur \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Drug interactions: rifabutin, rifampicin, methadone, ritonavir, efavirenz, carbamazepine, ranitidine, macrolides, sirolimus, cyclosporine, tacrolimus, warfarin, coumadin, statins, benzodiazepines, omeprazole, oral contraceptives and others. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Monitor serum levels. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">5-flucytosine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Symptomatic cystitis in patients not responding to or not treatable with fluconazole \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>mg/kg every 6<span class="elsevierStyleHsp" style=""></span>h 7–10 d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Emergence of resistance if given alone or for prolonged periods. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Adjust dose if renal insufficiency. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Gastrointestinal, liver and bone marrow toxicity \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959786.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Antifungal drugs.</p>" ] ] 5 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AMK: amikacin; GEN: gentamicin; ETM: streptomycin; EPT: spectinomycin; KAN: kanamycin; TOB: tobramycin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AMK \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">GEN \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ETM \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EPT \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">KAN \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TOB \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959788.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Interactions between aminoglycosides and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a></p>" ] ] 6 => array:7 [ "identificador" => "tbl0035" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">AMP: ampicillin; AMC: amoxicillin–clavulanate; CLO: cloxacillin; NAF: nafcillin; CFU: cefuroxime; CFZ: ceftazidime; CFX: ceftriaxone; AZT: aztreonam; IMI: imipenem; TIC: ticarcillin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AMP \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AMC \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CLO \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NAF \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CFU \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CFZ \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CFX \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AZT \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IMI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TIC \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959781.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0030">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Interactions between beta-lactams and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a></p>" ] ] 7 => array:7 [ "identificador" => "tbl0040" "etiqueta" => "Table 8" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">CIP: ciprofloxacin; LEV: levofloxacin; MOX: moxifloxacin; NAL: nalidixic acid; NOR: norfloxacin; OFL: ofloxacin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CIP \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LEV \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MOX \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NAL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NOR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OFL \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">a \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959784.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; NA: data not available; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Interactions between quinolones and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">a</span></a></p>" ] ] 8 => array:7 [ "identificador" => "tbl0045" "etiqueta" => "Table 9" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">TIG: tigecycline; VAN: vancomycin; DAP: daptomycin; LIN: linezolid; COT: cotrimoxazole; DOX: doxycycline; FOS: fosfomycin; CLI: clindamycin; MET: metronidazole; FID: fidaxomicin.</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">NA: Not analyzed.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TIG \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VAN \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DAP \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LIN \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">COT \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DOX \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FOS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CLI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MET \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FID \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959783.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; NA: data not available; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Interactions between other antibiotics and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">a</span></a></p>" ] ] 9 => array:7 [ "identificador" => "tbl0050" "etiqueta" => "Table 10" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">KET: ketoconazole; ITR: itraconazole; FLU: fluconazole; VOR: voriconazole; POS: posaconazole; CAS: caspofungin; MIC: micafungin; ANI: anidulafungin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">KET \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ITR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FLU \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VOR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">POS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CAS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MIC \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ANI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">e</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">a \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">a \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">a \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">a \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959790.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0045">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; NA: data not available; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] 1 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0050">It is recommended to reduce the dose of cyclosporine<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50%.</p>" ] 2 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0055">It is recommended to reduce the dose of cyclosporine<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25%.</p>" ] 3 => array:3 [ "identificador" => "tblfn0060" "etiqueta" => "d" "nota" => "<p class="elsevierStyleNotepara" id="npar0060">It is recommended to reduce the dose of tacrolimus<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>33%.</p>" ] 4 => array:3 [ "identificador" => "tblfn0065" "etiqueta" => "e" "nota" => "<p class="elsevierStyleNotepara" id="npar0065">It is recommended to reduce the dose of sirolimus<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50%.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Interactions between azoles, echinocandins and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">a</span></a></p>" ] ] 10 => array:7 [ "identificador" => "tbl0055" "etiqueta" => "Table 11" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">FUC: flucytosine; ABD: amphotericin B deoxycholate; ABL: liposomal amphotericin B; ABC: amphotericin lipid complex.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Immunosuppressants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FUC \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ABD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ABL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ABC \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cyclosporine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tacrolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mycophenolate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sirolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Everolimus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Prednisone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Basiliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muromonab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab959780.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0070" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0070">A/a: these drugs should not be co-administered; B/b: potential interaction – may require monitoring of plasma levels and graft function and/or change in dose; C/c: no clinically relevant interactions; NA: data not available; A, B, C: indicate that interaction has been described; a, b, c: indicate that interaction is based on a prediction guided by the pharmacokinetic characteristics of the product.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Interactions between flucytosine, polyenes and immunosuppressants.<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">a</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Reference" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of urinary tract infection in solid organ transplant recipients: Consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in infectious Diseases (REIPI)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Vidal" 1 => "C. Cervera" 2 => "E. Cordero" 3 => "C. Armiñanzas" 4 => "J. Carratalá" 5 => "J.M. Cisneros" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2015" "volumen" => "33" "paginaInicial" => "679.e1" "paginaFinal" => "679.e21" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack197727" "titulo" => "Acknowledgements" "texto" => "<p id="par0515" class="elsevierStylePara elsevierViewall">We thank Jesús Rodríguez-Baño MD, PhD and member of SEIMC for his comments on the manuscript.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/0213005X/0000003300000010/v1_201512110028/S0213005X15001433/v1_201512110028/en/main.assets" "Apartado" => array:4 [ "identificador" => "44301" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Documentos de consenso" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0213005X/0000003300000010/v1_201512110028/S0213005X15001433/v1_201512110028/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X15001433?idApp=UINPBA00004N" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 12 | 0 | 12 |
2024 October | 46 | 24 | 70 |
2024 September | 47 | 22 | 69 |
2024 August | 44 | 22 | 66 |
2024 July | 52 | 23 | 75 |
2024 June | 34 | 8 | 42 |
2024 May | 31 | 15 | 46 |
2024 April | 56 | 17 | 73 |
2024 March | 77 | 15 | 92 |
2024 February | 37 | 4 | 41 |
2024 January | 26 | 7 | 33 |
2023 December | 35 | 8 | 43 |
2023 November | 55 | 11 | 66 |
2023 October | 56 | 16 | 72 |
2023 September | 33 | 4 | 37 |
2023 August | 31 | 6 | 37 |
2023 July | 28 | 8 | 36 |
2023 June | 32 | 12 | 44 |
2023 May | 28 | 5 | 33 |
2023 April | 19 | 12 | 31 |
2023 March | 24 | 12 | 36 |
2023 February | 21 | 9 | 30 |
2023 January | 28 | 13 | 41 |
2022 December | 32 | 15 | 47 |
2022 November | 46 | 18 | 64 |
2022 October | 20 | 20 | 40 |
2022 September | 37 | 18 | 55 |
2022 August | 49 | 13 | 62 |
2022 July | 37 | 14 | 51 |
2022 June | 61 | 13 | 74 |
2022 May | 107 | 17 | 124 |
2022 April | 108 | 14 | 122 |
2022 March | 194 | 14 | 208 |
2022 February | 223 | 7 | 230 |
2022 January | 105 | 17 | 122 |
2021 December | 59 | 19 | 78 |
2021 November | 114 | 19 | 133 |
2021 October | 33 | 19 | 52 |
2021 September | 22 | 21 | 43 |
2021 August | 31 | 10 | 41 |
2021 July | 36 | 18 | 54 |
2021 June | 22 | 14 | 36 |
2021 May | 30 | 17 | 47 |
2021 April | 53 | 33 | 86 |
2021 March | 37 | 18 | 55 |
2021 February | 32 | 14 | 46 |
2021 January | 32 | 24 | 56 |
2020 December | 35 | 22 | 57 |
2020 November | 31 | 15 | 46 |
2020 October | 41 | 13 | 54 |
2020 September | 57 | 25 | 82 |
2020 August | 57 | 26 | 83 |
2020 July | 31 | 24 | 55 |
2020 June | 23 | 20 | 43 |
2020 May | 37 | 28 | 65 |
2020 April | 24 | 17 | 41 |
2020 March | 28 | 11 | 39 |
2020 February | 53 | 12 | 65 |
2020 January | 32 | 23 | 55 |
2019 December | 48 | 24 | 72 |
2019 November | 46 | 28 | 74 |
2019 October | 28 | 28 | 56 |
2019 September | 38 | 22 | 60 |
2019 August | 40 | 37 | 77 |
2019 July | 44 | 45 | 89 |
2019 June | 63 | 52 | 115 |
2019 May | 133 | 107 | 240 |
2019 April | 85 | 52 | 137 |
2019 March | 26 | 16 | 42 |
2019 February | 28 | 24 | 52 |
2019 January | 27 | 10 | 37 |
2018 December | 14 | 9 | 23 |
2018 November | 23 | 3 | 26 |
2018 October | 35 | 9 | 44 |
2018 September | 15 | 9 | 24 |
2018 August | 10 | 21 | 31 |
2018 July | 14 | 5 | 19 |
2018 June | 13 | 4 | 17 |
2018 May | 22 | 9 | 31 |
2018 April | 23 | 9 | 32 |
2018 March | 26 | 7 | 33 |
2018 February | 22 | 3 | 25 |
2018 January | 20 | 2 | 22 |
2017 December | 31 | 1 | 32 |
2017 November | 39 | 17 | 56 |
2017 October | 18 | 7 | 25 |
2017 September | 16 | 17 | 33 |
2017 August | 17 | 5 | 22 |
2017 July | 15 | 3 | 18 |
2017 June | 28 | 25 | 53 |
2017 May | 22 | 6 | 28 |
2017 April | 16 | 10 | 26 |
2017 March | 22 | 29 | 51 |
2017 February | 17 | 2 | 19 |
2017 January | 34 | 11 | 45 |
2016 December | 25 | 3 | 28 |
2016 November | 30 | 3 | 33 |
2016 October | 56 | 5 | 61 |
2016 September | 48 | 13 | 61 |
2016 August | 30 | 11 | 41 |
2016 July | 38 | 2 | 40 |
2016 June | 49 | 14 | 63 |
2016 May | 30 | 1 | 31 |
2016 April | 27 | 19 | 46 |
2016 March | 44 | 37 | 81 |
2016 February | 28 | 29 | 57 |
2016 January | 69 | 55 | 124 |
2015 December | 64 | 75 | 139 |