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Amoxycillin/clavulanate prophylaxis for extracorporeal shock wave lithotripsy--a comparative study
H Claes1, R Vandeursen, L Baert
1Department of Urology, Academic Hospital St. Pieter, Leuven, Belgium.
The Journal of Antimicrobial Chemotherapy
|November 1, 1989
Summary
Prophylactic antibiotics like amoxycillin/clavulanate significantly reduce urinary tract infections after extracorporeal shock wave lithotripsy (ESWL). This benefit extends even to patients without pre-existing infection risk factors.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Urinary tract infections (UTIs) are a potential complication following extracorporeal shock wave lithotripsy (ESWL).
- Prophylactic antibiotic use before ESWL is debated, especially in patients without identified infection risk factors.
Purpose of the Study:
- To evaluate the efficacy of prophylactic amoxycillin/clavulanate in preventing post-ESWL UTIs in outpatient settings.
- To compare infection rates between patients receiving prophylactic antibiotics and a control group.
Main Methods:
- A prospective randomized trial involving 181 patients with sterile urine undergoing outpatient ESWL.
- One group received a single intravenous dose of amoxycillin/clavulanate, while the control group received no antibiotic prophylaxis.
Main Results:
- The prophylactic group showed significantly lower rates of clinical UTI signs, leucocyturia, and positive urine cultures compared to the control group.
- Abnormal erythrocyte sedimentation rate (ESR) and peripheral leucocyte counts were also less frequent in the antibiotic prophylaxis group.
Conclusions:
- Single-dose prophylactic amoxycillin/clavulanate is effective in preventing UTIs after ESWL, even in patients without specific infection risk factors.
- Antibiotic prophylaxis before ESWL offers significant clinical benefits in reducing postoperative infectious complications.
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