Purpose: To examine the effects of antibiotic prophylaxis on post-operative infection rate in patients with negative urine cultures undergoing ureteroscopy (URS).
Patients and Methods: Using the Clinical Research Office of the Endourological Society (CROES) URS Global Study database, patients with a negative baseline urine culture undergoing URS for ureteral stones (n = 1141) or kidney stones (n = 184) not receiving antibiotic prophylaxis were matched with those who were by predefined risk factors, including gender, American Society of Anesthesiologists (ASA) score, and ureteral stent placement. Patient characteristics, operative data and post-operative outcomes, including the development of urinary tract infection (UTI) and fever, in the two groups were compared.
Results: Antibiotic prophylaxis use varied widely across participating countries (13-100%). Differences were found between patients who did or did not receive antibiotic prophylaxis regarding the frequency of anticoagulation medication, previous treatment with URS, stone burden, previous presence of kidney stones, duration of current URS, and complications post-URS. The prevalence of fever and UTI was low (≤ 2.2%) and similar in both groups. Factors predictive of post-operative UTI or fever were female gender, Crohn's and cardiovascular disease, a high stone burden, and an ASA score of II or higher.
Conclusions: In patients with a negative baseline urine culture undergoing URS for ureteral or renal stones, rates of post-operative UTI and fever were not reduced by pre-operative antibiotic prophylaxis. Female gender, and high ASA score were specific risk factors for post-operative infection in this patient group.
Written by:
Martov A, Gravas S, Radfar MH, Unsal A, Barusso GH, D'Addessi A, Krambeck AE, De La Rosette J. Are you the author?
Municipal clinical hospital #57 of Moscow, EndoUrology, 3 parkovaya, 51, Moscow, Russian Federation, 105425.
Reference: J Endourol. 2014 Jul 29. Epub ahead of print.
doi: 10.1089/end.2014.0470
PubMed Abstract
PMID: 25072350
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