Perioperative Prophylaxis for Percutaneous Nephrolithotomy: Randomized Study Concerning the Drug and Dosage

Seyrek, Mahir; Binbay, Murat; Yürük, Emrah; Akman, Tolga; Aslan, Rahmi; Yazıcı, Özgür; Berberoğlu, Y.; Müslümanoğlu, Ahmet Yaser

doi:10.1089/end.2012.0242

Cited by 46 publications

(36 citation statements)

References 19 publications

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“…Previously reported rates of SIRS after PCNL demonstrate a wide range: 9.8%–56.7% [2122]. This variability may be attributed to several causes.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Dogan et al [25] found no difference in rates of post-PCNL fever in patients who received a single preoperative dose versus a postoperative course extending to nephrostomy tube removal. Seyrek et al [22] prospectively randomized 198 patients to receive a single postoperative dose, an additional dose at 12 hours post-PCNL, or antibiotics until the time of nephrostomy tube removal. The authors found no difference in rates of SIRS between the groups.…”

Section: Discussionmentioning

confidence: 99%

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Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

et al. 2016

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PurposeThe goal of this study was to compare the rate of systemic inflammatory response syndrome (SIRS) in high-risk patients undergoing percutaneous nephrolithotomy (PCNL) between patients who received 7, 2, or 0 days of preoperative antibiotics.Materials and MethodsWe retrospectively reviewed a series of consecutive PCNLs performed at our institution. Patients with infected preoperative urine cultures were excluded. High-risk patients were defined as those with a history of previous urinary tract infection (UTI), hydronephrosis, or stone size ≥2 cm. Patients were treated with 7, 2, or 0 days of preoperative antibiotic prophylaxis prior to PCNL. All patients received a single preoperative dose of antibiotics within 60 minutes of the start of surgery. Fisher exact test was used to compare the rate of SIRS by preoperative antibiotic length.ResultsOf the 292 patients identified, 138 (47.3%) had sterile urine and met high-risk criteria, of which 27 (19.6%), 39 (28.3%), and 72 (52.2%) received 7, 2, and 0 days of preoperative antibiotics, respectively. The 3 groups were similar in age, sex, and duration of surgery (p>0.05). There was no difference in the rate of SIRS between the groups, with 1 of 27 (3.7%), 2 of 39 (5.1%) and 3 of 72 patients (4.2%) meeting criteria in the 7, 2, and 0 days antibiotic groups (p=~1).ConclusionsExtended preoperative antibiotic prophylaxis was not found to reduce the risk of SIRS after PCNL in our institutional experience of high-risk patients. For these patients, a single preoperative dose of antibiotics is sufficient.

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“…Previously reported rates of SIRS after PCNL demonstrate a wide range: 9.8%–56.7% [2122]. This variability may be attributed to several causes.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

et al. 2016

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“…Various regimens of antibiotic prophylaxis are implemented to prevent upper urinary system infections and urosepsis (12,13,14). There is a general tendency to apply a short-term antibiotic course, which typically lasts 48 hours after PCNL (15).…”

Section: Discussionmentioning

confidence: 99%

Can Neutrophil Count, Lymhocyte Count and Neutrophil-tolymphocyte Ratio Predict Fever Following Percutaneous Nephrolithotomy in Patients Without Risk Factors?

Demirtaş¹,

Baydilli²,

Tombul³

et al. 2020

jus

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Objective: To examine the relationship of neutrophil counts, lymphocyte count and neutrophil-to-lymphocyte ratio (NLR) with postoperative fever in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: A total of 519 patients aged over 18 years, who underwent PCNL between January 2005 and January 2013 and had a preoperative white blood cell count between 4000-12,000/µL, were included in this study. Conditions that could lead to postoperative fever or impact blood parameters constituted the exclusion criteria. At the postoperative period, the patients were divided into two groups based on the presence of fever. Age, gender, Body Mass index, stone size, number of percutaneous access, duration of operation, preoperative white blood cell count, neutrophils, lymphocytes, and NLR were compared. The relationship of these parameters with fever was evaluated with univariate and multivariate analyses. Results: The group with fever included 50 patients and the group without fever, 469 patients. The difference between the two groups was statistically significant in terms of neutrophil and lymphocyte counts, and NLR. Univariate analysis revealed that preoperative thrombocyte count, lymphocyte count, neutrophil count, and NLR were the parameterss significantly related with fever, yet, in multivariate analysis, the only statistically significant parameters related with post-PCNL fever were age, thrombocyte count, and white blood cell count. Conclusion: When risk factors for fever are excluded, lymphocyte count and NLR appear to be easy-to-use and affordable diagnostic markers to predict postoperative fever in patients undergoing PCNL.Amaç: Perkütan nefrolitotomi (PNL) yapılan hastalarda lenfosit sayısı ve nötrofil lenfosit oranı (NLO) ile post operatif ateş arasındaki ilişkiyi değerlendirmek. Gereç ve Yöntem: Ocak 2005 -Ocak 2013 tarihleri arasında PNL yapılan 519 hasta çalışmaya alındı. Çalışmaya; 18 yaş ve üzeri, preoperatiferatif beyaz küre sayısı 4000-12,000 10 3 /µL arasında olan hastalar alındı. Postoperatif dönemde ateş yapabilecek ya da kan parametrelerini etkileyecek durumlar çalışma dışı bırakıldı. Postoperatif dönemde hastalar ateşi 38,5 °C üzeri olan ve ateşi olmayan olarak iki gruba ayrıldı. Bulgular: Ateş olan grupta 50 hasta, ateş olmayan grupta 469 hasta vardı. Gruplar arasında yaş, cinsiyet, Beden Kitle indeksi, giriş sayısı, taş boyutu, beyaz küre ve trombosit sayısı bakımından istatistiksel olarak anlamlı farklılık yoktu. Ancak nötrofil sayısı, lenfosit sayısı ve NLO değerleri arasında Abstract Öz

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“…The risk of infection in PNL is high and use of ABP has been shown to significantly reduce the risk of infectious complications [351][352][353][354][355][356][357][358][359] (LE: 1b, GR: A). A single dose has shown to be sufficient [360]. Retrograde intra-renal stone treatment could be expected to have a similar risk profile [350].…”

Section: N424 Percutaneous Nephrolithotripsymentioning

confidence: 99%

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Amaral

Pereira

Rodrigues

et al. 2019

Porto Biomedical Journal

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Background: Urinary tract infection (UTI) is a common complication of spinal cord injury (SCI). Urodynamic testing is widely used for characterization of vesico-sphincteric dysfunction and for therapeutic orientation. As an invasive procedure, the risk of UTI is increased so, in some medical centers, antibiotic prophylaxis is instituted. Fosfomycin is one of the antibiotics used. Objective: The aim of this study was to evaluate the incidence of UTI after urodynamics in patients with SCI, under fosfomycin prophylaxis. Methods: Retrospective analysis was performed on patients with SCI, admitted to a rehabilitation center between January 2016 and June 2017, who underwent urodynamics studies under fosfomycin prophylaxis. Demographic data, risk factors for UTI—bacteriuria before urodynamics, high residual volume (>100 mL), bladder emptying method, vesico-sphincteric dyssynergia, and detrusor hyperactivity were analyzed. The incidence of UTI after urodynamics was evaluated. Results: The study included 84 patients, predominantly men 55 (65.5%). The mean age of the patients was 55.6 (18.9). Eleven (22.5%) had vesico-sphincteric dyssynergia, 32 (65.3%) detrusor hyperactivity and 22 (44.9%) had a high residual volume. Thirty-seven (44.1%) had asymptomatic bacteriuria before the urodynamics. Urinary complaints suggestive of UTI after urodynamics were observed in 2(2.4%) of patients, without significant bacteriuria and identification of bacterial agent. Conclusions: The incidence of UTI after invasive procedures is reported between 3% and 20% in the literature, so antibiotic prophylaxis has been instituted, although controversial. In the study, in none of the patients the diagnosis of UTI was confirmed. Fosfomycin prophylaxis may have been important in reducing the incidence of UTI.

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Perioperative Prophylaxis for Percutaneous Nephrolithotomy: Randomized Study Concerning the Drug and Dosage

Abstract: Sulbactam-ampicillin and cefuroxime antibiotics can be used safely for prophylaxis of PCNL. Single dose administration is sufficient.

Cited by 46 publications

References 19 publications

Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

Can Neutrophil Count, Lymhocyte Count and Neutrophil-tolymphocyte Ratio Predict Fever Following Percutaneous Nephrolithotomy in Patients Without Risk Factors?

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

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