The Role of Antibiotic Prophylaxis in Percutaneous Nephrolithotomy.

Postoperative sepsis is the most common cause of mortality after percutaneous nephrolithotomy (PCNL) procedures. Studies investigating the use of antibiotics in PCNL patients have shown that prophylactic antibiotic regimens can reduce the rate of postoperative infectious complications. In addition, several studies have identified risk factors for sepsis development that can help guide antibiotic treatment and perioperative care overall. This has led the American Urological Association to recommend antibiotic prophylaxis for PCNL as a best practice policy statement. However, despite prophylaxis, postoperative sepsis has continued to remain the leading cause of mortality in PCNL patients. In addition, multiple antibiotic protocols exist within the guideline realms. This review assesses the development and role of antibiotic prophylaxis for PCNL procedures.