Cytomegalovirus antiviral stewardship considerations in solid organ transplant patients

Antimicrobial stewardship has a role in the immunocompromised host, and CMV antiviral stewardship is a unique application in solid organ transplant. Utilization of this initiative can improve outcomes related to CMV, particularly in the high-risk population providing a proactive, dedicated effort with a well-established infrastructure for effective surveillance after prophylaxis. Targeted quality improvement initiatives can further personalize the initiative to address issues unique to each transplant center. Large scale or all-encompassing efforts are not required to obtain substantial benefit.