Sameer Deshmukh1, Kevan Sternberg1, Natalia Hernandez1, Brian H Eisner2. 1. Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Urology, University of Vermont College of Medicine (KS), Burlington, Vermont. 2. Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Urology, University of Vermont College of Medicine (KS), Burlington, Vermont. Electronic address: beisner@partners.org.
Abstract
PURPOSE: We compared infection rates after percutaneous nephrolithotomy in a group of patients without a history of infection or struvite calculi who received 24 hours or less of antibiotics postoperatively (ie compliance with AUA guidelines) vs a group that received 5 to 7 days of antibiotics postoperatively. MATERIALS AND METHODS: We retrospectively reviewed the records of consecutive percutaneous nephrolithotomy procedures in patients without a history of urinary tract infection. Group 1 received 24 hours or less of antibiotics postoperatively and group 2 received a mean of 6 days of antibiotics postoperatively. RESULTS: A total of 52 patients in group 1 (24 hours or less of antibiotics) and 30 in group 2 (mean 6 days of antibiotics) met study inclusion criteria. In 5 group 1 patients (9.6%) fever developed within 72 hours of percutaneous nephrolithotomy but none demonstrated bacteriuria or bacteremia on cultures. No patient in group 1 was treated for urinary tract infection on postoperative days 3 to 14. In 4 group 2 patients (13.3%) fever developed within 72 hours of percutaneous nephrolithotomy. A single patient showed bacteriuria (less than 10,000 cfu mixed gram-positive bacteria) on culture while no patient demonstrated bacteremia. No patient in group 2 was treated for urinary tract infection on postoperative days 3 to 14. There was no difference in stone-free rates or the need for additional procedures between the 2 groups. CONCLUSIONS: In this pilot series compliance with AUA guidelines for antibiotic prophylaxis did not result in higher rates of infection than in a comparable group of 30 patients who received approximately 6 days of antibiotics postoperatively.
PURPOSE: We compared infection rates after percutaneous nephrolithotomy in a group of patients without a history of infection or struvite calculi who received 24 hours or less of antibiotics postoperatively (ie compliance with AUA guidelines) vs a group that received 5 to 7 days of antibiotics postoperatively. MATERIALS AND METHODS: We retrospectively reviewed the records of consecutive percutaneous nephrolithotomy procedures in patients without a history of urinary tract infection. Group 1 received 24 hours or less of antibiotics postoperatively and group 2 received a mean of 6 days of antibiotics postoperatively. RESULTS: A total of 52 patients in group 1 (24 hours or less of antibiotics) and 30 in group 2 (mean 6 days of antibiotics) met study inclusion criteria. In 5 group 1 patients (9.6%) fever developed within 72 hours of percutaneous nephrolithotomy but none demonstrated bacteriuria or bacteremia on cultures. No patient in group 1 was treated for urinary tract infection on postoperative days 3 to 14. In 4 group 2 patients (13.3%) fever developed within 72 hours of percutaneous nephrolithotomy. A single patient showed bacteriuria (less than 10,000 cfu mixed gram-positive bacteria) on culture while no patient demonstrated bacteremia. No patient in group 2 was treated for urinary tract infection on postoperative days 3 to 14. There was no difference in stone-free rates or the need for additional procedures between the 2 groups. CONCLUSIONS: In this pilot series compliance with AUA guidelines for antibiotic prophylaxis did not result in higher rates of infection than in a comparable group of 30 patients who received approximately 6 days of antibiotics postoperatively.
Authors: Daniel A Wollin; Adrian D Joyce; Mantu Gupta; Michael Y C Wong; Pilar Laguna; Stavros Gravas; Jorge Gutierrez; Luigi Cormio; Kunjie Wang; Glenn M Preminger Journal: World J Urol Date: 2017-02-03 Impact factor: 4.226
Authors: Aaron M Potretzke; Alyssa M Park; Tyler M Bauman; Jeffrey A Larson; Joel M Vetter; Brian M Benway; Alana C Desai Journal: Investig Clin Urol Date: 2016-10-24