Kidney transplant performed at a UCSF facility within the last 6 months
Most recent glomerular filtration rate (GFR) \>30 mL/min/1.73 m2
Tolerated initial 6 months of post-transplant TMP-SMX (defined as no intentional periods of TMP-SMX cessation in first 6 months after transplant due to hyperkalemia, allergic reaction, or unexpected/excessive neutropenia)
You may not be if
History of intolerance or allergy to trimethoprim (TMP) and/or sulfamethoxazole (SMX)
History of UTI due to a TMP-SMX-resistant organism in the first 6 months after transplant
Moderate or severe neutropenia (absolute neutrophil count \<1,000 cells/μL) on most recent bloodwork available at the time of recruitment
Uncontrolled hyperkalemia (serum potassium ≥5.0 mEq/L) on most recent bloodwork available at the time of recruitment
Provider-determined/documented need for either continuation or discontinuation of TMP-SMX prophylaxis that would preclude the patient's randomization
Current pregnancy
Incarcerated individuals/prisoners
Inability to provide informed consent or assent, and no legally authorized representative available
Clareo Health | Antibiotics for Kidney Transplant Recipients
