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[Prophylactic antibiotic therapy in extracorporeal shock-wave lithotripsy: prospective, randomized study]
J E Robles1, F De Castro, M C Frades
1Departamento de Urología, Facultad de Medicina, Universidad de Navarra, Pamplona.
Actas Urologicas Espanolas
|September 1, 1991
Summary
Antibiotic prophylaxis, including cephalosporin or quinolone, did not significantly reduce bacteriuria after extracorporeal shock wave lithotripsy (ESWL). Therefore, ESWL can be safely performed without antibiotics in patients without specific risk factors.
Area of Science:
- Urology
- Infectious Diseases
- Nephrology
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stone removal.
- The necessity of antibiotic prophylaxis to prevent urinary tract infections post-ESWL is debated.
- Bacteriuria is a potential complication following ESWL.
Purpose of the Study:
- To evaluate the effectiveness of antibiotic prophylaxis in preventing bacteriuria after ESWL.
- To compare the impact of different antibiotic classes (cephalosporin, quinolone) on post-ESWL bacteriuria rates.
Main Methods:
- A randomized controlled trial involving 200 patients undergoing ESWL.
- Patients were divided into four groups to assess different antibiotic prophylaxis regimens.
- Bacteriuria rates were monitored post-procedure.
Main Results:
- No statistically significant differences in bacteriuria rates were observed among the four groups.
- Neither cephalosporin nor quinolone prophylaxis demonstrated a significant impact on reducing bacteriuria.
- The study found no benefit of routine antibiotic prophylaxis in this patient cohort.
Conclusions:
- Antibiotic prophylaxis is not necessary for patients undergoing ESWL who do not have infected stones, urinary tract obstruction, or require ancillary procedures.
- ESWL can be safely performed without prophylactic antibiotics in low-risk patients.
- Further research may explore specific high-risk subgroups.