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Routine Antibiotic Prophylaxis Is Not Required for Patients Undergoing Shockwave Lithotripsy: Outcomes from a
Cameron E Alexander1, Stuart Gowland2, Jon Cadwallader3
11 School of Medicine and Dentistry, University of Aberdeen , Aberdeen, United Kingdom .
Journal of Endourology
|October 5, 2016
Summary
Routine prophylactic antibiotics do not prevent urinary tract infections (UTIs) after extracorporeal shockwave lithotripsy (SWL). This large New Zealand study found no significant benefit from antibiotic use in preventing UTIs post-SWL.
Area of Science:
- Urology
- Infectious Disease Prevention
- Medical Technology Assessment
Background:
- Urinary tract infections (UTIs) are a potential complication following extracorporeal shockwave lithotripsy (SWL).
- The efficacy of routine prophylactic antibiotics in preventing post-SWL UTIs remains a subject of clinical debate.
Purpose of the Study:
- To evaluate the effectiveness of routine prophylactic antibiotics in preventing UTIs after SWL.
- To identify predictors of UTI development in a large cohort undergoing SWL.
Main Methods:
- A multicenter study analyzed over 10,000 stone cases treated with SWL in New Zealand from 1995 to 2014.
- Data included patient, stone, and treatment characteristics; clinical UTI was defined as requiring antibiotic therapy.
- Multivariate analysis identified factors associated with post-SWL UTI development.
Main Results:
- Prophylactic antibiotics were used in 62.1% of cases, with no significant difference in UTI rates (1.1% vs 1.3%) compared to no prophylaxis.
- Antibiotic prophylaxis was not independently associated with a reduced risk of post-SWL UTI.
- Predictors of UTI included female gender, larger stone size, and a higher number of delivered shocks.
Conclusions:
- Routine antibiotic prophylaxis is not associated with a reduction in clinical UTI after SWL in this large cohort.
- The findings suggest that routine antibiotic prophylaxis may not be beneficial for all patients undergoing SWL.