Shorter Antibiotic Course Doesn't Up Infection After Nephrolithotomy
Findings based upon 24 hours versus six days of antibiotics with percutaneous nephrolithotomy
(HealthDay News) -- Compliance with American Urological Association (AUA) guidelines for shorter antibiotic prophylaxis does not result in higher rates of infection among patients undergoing percutaneous nephrolithotomy, according to a study published in The Journal of Urology.
Sameer Deshmukh, M.D., from Massachusetts General Hospital in Boston, and colleagues retrospectively reviewed the records of consecutive percutaneous nephrolithotomy procedures in patients without a history of urinary tract infection. Patients were grouped based on duration of postoperative antibiotics: group 1: ≤24 hours (52 patients); group 2: mean of 6 days (30 patients).
The researchers found that fever developed within 72 hours of percutaneous nephrolithotomy in 5 group-1 patients (9.6%), but none demonstrated bacteriuria or bacteremia on cultures. Furthermore, no group-1 patients were treated for urinary tract infection on postoperative days 3 to 14. In group 2, 4 patients (13.3%) developed fever within 72 hours of percutaneous nephrolithotomy and 1 patient showed bacteriuria on culture (<10,000 colony-forming units mixed gram-positive bacteria). No group-2 patients demonstrated bacteremia or were treated for urinary tract infection on postoperative days 3 to 14. Stone-free rates and the need for additional procedures were similar between the 2 groups.
"In this pilot series, compliance with AUA guidelines for antibiotic prophylaxis did not result in higher rates of infection than in a comparable group of 30 patients who received approximately 6 days of antibiotics postoperatively," the authors write.
One author disclosed financial ties to the medical device industry.