Postoperative infection rates in low risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis: A matched case control study

Stavros Gravas, Emanuele Montanari, Petrisor Geavlete, Bulent Onal, Andreas Skolarikos, Margaret S Pearle, Ying Hao Sun, Jean De La Rosette

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: Current guidelines recommend prophylactic antibiotic therapy for all patients undergoing percutaneous nephrolithotomy. We examined the effects of antibiotic prophylaxis in patients undergoing percutaneous nephrolithotomy with negative preoperative urine cultures. Materials and Methods: Of the 5,803 patients in the CROES (Clinical Research Office of the Endourological Society) Percutaneous Nephrolithotomy Global Study database, a group of 162 patients undergoing percutaneous nephrolithotomy with a negative baseline urine culture who did not receive antibiotic prophylaxis were matched on preoperative nephrostomy, the presence of staghorn calculi and diabetes status with an equal number of patients who received antibiotic prophylaxis. Comparisons were made between the 2 groups in terms of operative and postoperative outcomes, including the incidence of fever and other complications. Results: Patients who received antibiotic prophylaxis had a lower mean (SD) age at 44.9 (14.2) vs 50.1 (14.4) years (p = 0.001). They were also more likely to be in the prone position during the procedure (71.6% vs 39.5%, p <0.001) but less likely to receive postoperative stenting (17.3% vs 32.7%, p = 0.002) than those who did not receive prophylaxis. The 2 groups were comparable in terms of all other baseline characteristics and operative factors. Patients who received antibiotic prophylaxis were less likely to experience fever (2.5% vs 7.4%, p = 0.040) and other postoperative complications (1.9% vs 22.0%, p <0.0001), and had a higher stone-free rate after percutaneous nephrolithotomy (86.3% vs 74.4%, p = 0.006). Conclusions: Antibiotic prophylaxis of patients undergoing percutaneous nephrolithotomy with a negative baseline urine culture is associated with a significant reduction in the rate of postoperative fever and other complications.

Original languageEnglish (US)
Pages (from-to)843-847
Number of pages5
JournalJournal of Urology
Volume188
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Percutaneous Nephrostomy
Antibiotic Prophylaxis
Case-Control Studies
Infection
Fever
Urine
Prone Position
Databases
Guidelines
Anti-Bacterial Agents
Incidence

Keywords

  • antibiotic prophylaxis
  • infection
  • nephrostomy
  • percutaneous
  • postoperative complications

ASJC Scopus subject areas

  • Urology

Cite this

Postoperative infection rates in low risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis : A matched case control study. / Gravas, Stavros; Montanari, Emanuele; Geavlete, Petrisor; Onal, Bulent; Skolarikos, Andreas; Pearle, Margaret S; Sun, Ying Hao; De La Rosette, Jean.

In: Journal of Urology, Vol. 188, No. 3, 09.2012, p. 843-847.

Research output: Contribution to journalArticle

Gravas, Stavros ; Montanari, Emanuele ; Geavlete, Petrisor ; Onal, Bulent ; Skolarikos, Andreas ; Pearle, Margaret S ; Sun, Ying Hao ; De La Rosette, Jean. / Postoperative infection rates in low risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis : A matched case control study. In: Journal of Urology. 2012 ; Vol. 188, No. 3. pp. 843-847.
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abstract = "Purpose: Current guidelines recommend prophylactic antibiotic therapy for all patients undergoing percutaneous nephrolithotomy. We examined the effects of antibiotic prophylaxis in patients undergoing percutaneous nephrolithotomy with negative preoperative urine cultures. Materials and Methods: Of the 5,803 patients in the CROES (Clinical Research Office of the Endourological Society) Percutaneous Nephrolithotomy Global Study database, a group of 162 patients undergoing percutaneous nephrolithotomy with a negative baseline urine culture who did not receive antibiotic prophylaxis were matched on preoperative nephrostomy, the presence of staghorn calculi and diabetes status with an equal number of patients who received antibiotic prophylaxis. Comparisons were made between the 2 groups in terms of operative and postoperative outcomes, including the incidence of fever and other complications. Results: Patients who received antibiotic prophylaxis had a lower mean (SD) age at 44.9 (14.2) vs 50.1 (14.4) years (p = 0.001). They were also more likely to be in the prone position during the procedure (71.6{\%} vs 39.5{\%}, p <0.001) but less likely to receive postoperative stenting (17.3{\%} vs 32.7{\%}, p = 0.002) than those who did not receive prophylaxis. The 2 groups were comparable in terms of all other baseline characteristics and operative factors. Patients who received antibiotic prophylaxis were less likely to experience fever (2.5{\%} vs 7.4{\%}, p = 0.040) and other postoperative complications (1.9{\%} vs 22.0{\%}, p <0.0001), and had a higher stone-free rate after percutaneous nephrolithotomy (86.3{\%} vs 74.4{\%}, p = 0.006). Conclusions: Antibiotic prophylaxis of patients undergoing percutaneous nephrolithotomy with a negative baseline urine culture is associated with a significant reduction in the rate of postoperative fever and other complications.",
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