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Antimicrobial prophylaxis in management of urinary tract stones by extracorporeal shock-wave lithotripsy: is it
Y Ilker1, L N Türkeri, V Korten
1Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
Objectives:
In a prospective randomized study, we evaluated the incidence of urinary tract infections following extracorporeal shock-wave lithotripsy (ESWL) and the necessity of prophylactic antibiotic administration in patients treated with this modality.
Methods:
A total of 360 consecutive patients with renal and ureteric stones who had sterile urine before ESWL treatment and did not have any increased risk of infection received either a single dose of 400 mg of ofloxacin or no prophylaxis. Patients were followed by simple urine analysis and urine cultures together, with clinical evaluations.
Results:
Only 3 patients (0.8%) had positive urine cultures at 1 week after ESWL. Two of these patients were in the antibiotic prophylaxis group.
Conclusions:
The incidence of urinary tract infections after ESWL is extremely low, provided that patients have sterile urine before ESWL, and prophylactic antibiotics are not required.