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A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
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[Prophylatic antibiotic use in percutaneous nephrolithotomy: a meta-analysis]
Ming-gen Yang1, Zhou-da Zheng1, Zhen-qiang Xu1
1Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|January 18, 2014
Summary
Prophylactic antibiotics significantly reduce postoperative infections like fever and bacteriuria in percutaneous nephrolithotomy (PCNL) patients with sterile urine. Quinolones and extended antibiotic courses show particular effectiveness in preventing these complications.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Context:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- Patients undergoing PCNL with sterile preoperative urine are still at risk for postoperative infective complications.
- The role of antibiotic prophylaxis in mitigating these risks requires clear definition.
Purpose:
- To evaluate the efficacy of antibiotic prophylaxis in reducing postoperative infective complications following PCNL in patients with sterile preoperative urine.
- To compare the effectiveness of different antibiotic classes and durations of treatment.
Summary:
- A meta-analysis of 9 randomized controlled trials involving 1018 patients was conducted.
- Prophylactic antibiotics significantly decreased the incidence of fever (RR = 0.71), bacteriuria (RR = 0.39), and bacteremia (RR = 0.43) in PCNL patients with sterile urine.
- Quinolones were effective in reducing bacteriuria, while nitrofurantoin reduced fever. An extended antibiotic course further decreased fever and bacteriuria.
Impact:
- Antibiotic prophylaxis is an effective strategy to minimize infectious complications after PCNL.
- Specific antibiotic choices, such as quinolones, and extended treatment durations can optimize outcomes.
- This evidence supports the routine use of prophylactic antibiotics in select PCNL patient populations.
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