Short course netilmicin prophylaxis in renal stone surgery

Area of Science:

• Nephrology
• Surgical Infectious Diseases
• Pharmacology

Background:

• Intrarenal calculi (kidney stones) surgery carries a high risk of severe wound complications, affecting up to 30% of patients.
• Bacterial presence is common in kidney stones (50% prevalence) and urine (20% prevalence), indicating a significant infection risk during surgical removal.

Purpose of the Study:

• To evaluate the efficacy of a short-term netilmicin antibiotic course in preventing wound complications after intrarenal calculi surgery.
• To assess the safety and pharmacokinetic profile of perioperative netilmicin administration in this patient cohort.

Main Methods:

• A prospective study involving 20 consecutive patients undergoing surgery for intrarenal calculi.
• Administration of a short course of netilmicin perioperatively.
• Monitoring of wound complications, serum netilmicin levels, and renal function (serum urea and creatinine).

Main Results:

• Only one patient (5%) experienced a wound complication, a significant reduction from the expected 30%.
• Satisfactory serum netilmicin levels were achieved post-dose, with no levels exceeding 1 microgram/mL at 7 hours.
• No adverse effects on renal function were observed, even in patients with pre-existing renal impairment.

Conclusions:

• Perioperative administration of netilmicin is effective in reducing severe wound complications following intrarenal calculi surgery.
• Short-term netilmicin prophylaxis is safe, achieving therapeutic levels without compromising renal function in the studied population.