A comparative study between a single dose pre-induction antibiotic versus continuous antibiotics to prevent urinary tract infection during ureteroscopy

Abstract

Background and objective: This study aimed to evaluate if the addition of postoperative antibiotics reduces the incidence of symptomatic urinary tract infections following ureteroscopic stone treatment beyond the recommended preoperative dose.Methods: This prospective comparative study was conducted between March and November 2017. A total of 80 patients with preoperative negative urine culture undergoing ureteroscopy were randomly allocated. All the patients received single dose antibiotic before the induction of anesthesia and a group of them also received postoperative antibiotics. The rate of symptomatic urinary tract infection was compared between the patients who received only preoperative antibiotics (group 1) and those who received pre-and postoperative antibiotics (group 2).Results: Eighty patients underwent ureteroscopy for stone treatment, the time to follow up was 4±2 weeks from ureteroscopy. Eleven (13.8%) patients in total developed urinary tract infections postoperatively, including five (12.5%) from group 1 and six (15%) from group 2, P=0.74. In group 1, four patients presented with cystitis and one with sepsis; those patients with infections in group 2 presented with pyelonephritis (n=2) and cystitis (n=4). Risk factors such as preoperative stenting, nephrostomy tubes, and Foleys catheters neither differed between groups nor did they predispose patients to postoperative infections. Conclusions:The postoperative symptomatic urinary tract infection rate in this study (13.8%) is in agreement with previous reports. This study suggests that a single preoperative dose of antibiotics is sufficient, and additional postoperative antibiotics do not decrease infection rates after ureteroscopic stone treatment.