To investigate the current status of antimicrobial stewardship (AMS) in kidney transplant centers and provide a reference for further standardizing the rational use of antimicrobial agents.

From April 4 to May 12, 2023, an online survey was conducted for clinical pharmacists specializing in kidney transplantation from 50 hospitals of the National Alliance of Transplant Pharmacists to collect information on AMS-related practices in their respective hospitals and kidney transplant centers. A questionnaire on the current status of AMS in kidney transplant centers was designed and distributed via the " Wenjuanxing" platform. The content included basic information about the responding pharmacists and their hospitals, evaluation indicators and completion status of clinical application management of antimicrobial agents, intervention measures taken by pharmacists and the effectiveness, as well as the rationality evaluation and suggestions from pharmacists on the perioperative infection prevention protocols for kidney transplantation.

A total of 23 transplant pharmacists from 23 teaching hospitals with Grade IIIA participated in the survey. AMS was implemented in 21 hospitals (91.3%), while only 10 hospitals (43.5%) had AMS programs in renal transplant centers. There were substantial differences in the target values for antimicrobial use intensity among the centers, and 5 centers (21.7%) failed to reach the standard. Twenty-two pharmacists had implemented interventions to improve the rational use of antimicrobial agents. Specific interventions included: training programs (19 cases, 86.4%), administrative interventions (12 cases, 54.5%), and the use of rational medication software to support AMS management (6 cases, 27.3%). The effects of interventions were mainly reflected as: shortened treatment courses (18 cases, 81.8%), adjustment of drug choice (12 cases, 54.5%), reduction in the number of combined antimicrobial agents (11 cases, 50.0%), and decreased dosage (6 cases, 27.3%). Twelve pharmacists (52.2%) approved of the current routine infection prophylaxis protocols for kidney transplantation in their centers, however, evaluations of the same protocol varied among different pharmacists.

The implementation rate of AMS in kidney transplant centers in China remains low, and there are substantial differences in AMS goals and implementation. High-quality studies are needed to explore homogeneous management strategies to standardize the rational use of antimicrobial agents.