Can Perioperative Antibiotic Choice Impact Rates of Infectious Complications After Percutaneous Nephrolithotomy? A...

Area of Science:

• Urology
• Infectious Disease
• Pharmacology

Background:

• National guidelines recommend antibiotics before percutaneous nephrolithotomy (PCNL).
• The comparative efficacy of guideline-recommended antibiotics for PCNL is not well-established.
• Systemic inflammatory response syndrome (SIRS) is a key outcome to monitor post-PCNL.

Purpose of the Study:

• To compare the efficacy of ciprofloxacin versus cefazolin for perioperative antibiotic prophylaxis in PCNL.
• To evaluate the incidence of SIRS criteria development in patients receiving either antibiotic.
• To assess other perioperative outcomes including hospitalization duration and intensive care unit (ICU) need.

Main Methods:

• A randomized trial involving 147 adult patients undergoing PCNL with negative preoperative urine cultures.
• Patients were randomized to receive either ciprofloxacin or cefazolin perioperatively.
• Data collected included demographic information, SIRS criteria, intraoperative urine cultures, and hospitalization duration.

Main Results:

• No significant differences were observed in intraoperative or postoperative findings between the ciprofloxacin and cefazolin groups (p > 0.05).
• Hospitalization duration was slightly longer in the cefazolin group (2 hours, p = 0.02).
• There was no statistically significant difference in the incidence of SIRS episodes between the two antibiotic groups in univariate and multivariate analyses.

Conclusions:

• Ciprofloxacin does not demonstrate superiority over cefazolin for perioperative antibiotic prophylaxis in non-high-risk PCNL patients.
• Both ciprofloxacin and cefazolin are appropriate antibiotic options for PCNL prophylaxis.
• Further research may explore antibiotic selection based on local resistance patterns.