Category: Clinical Stones: PCNL

MP12-10 - Appropriate use of perioperative antibiotics in percutaneous nephrolithotomy for patients with complex kidney stones

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

To investigate the appropriate antibiotic use of the antibiotic prophylaxis and the treatment of preoperative urinary tract infections (UTI) in percutaneous nephrolithotomy (PCNL) for patients with complex kidney stones.


Methods :

A total of 1060 complex kidney stone patients undergone PCNL from September 2016 to September 2017 were recruited. Perioperative antibiotic usage was registered in all patients including therapeutic antibiotics and antibiotic prophylaxis. 


Results :

Positive urine WBC was found in 378 (35.7%) patients, who were immediately treated with antibiotics empirically. 164 of them had positive urine cultures while 214 of them had negative urine cultures. 78 of 164 patients with positive urine cultures were treated with antibiotics more than 3 days based on cultures. The incidence of postoperative fever was higher in the group of empirical treatment (36.0%) than in the group of treatment based on cultures (16.7%) for patients with positive urine WBC and positive urine cultures (p<0.05). The incidence of postoperative fever was higher in patients with positive urine WBC and negative urine cultures (16.8%) than in patients with negative urine WBC and negative urine cultures (6.1%; p<0.05). Multiple doses of prophylactic antibiotics (5.1%) significantly reduced post-PCNL fever than single dose (10.6%; p<0.05). The occurrence of positive stone cultures was higher in fever patients treated with a single dose prophylactic antibiotic (70.0%) than in fever patients treated with multiple doses (26.1%; p<0.05). There were no significant differences of postoperative fever between prophylactic antibiotics of less than 3 days (3.2%) and more than 3 days (5.6%; p<0.05).


Conclusions :

The preoperative UTI should be treated with sensitive antibiotics more than 3 days based on urine cultures. Prophylactic antibiotics should be continued to the second days after PCNL for patients with complex kidney stones.

Wenqi Wu

urologist
First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)

Dong Chen

First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)

Wenqi Wu

urologist
First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China (People's Republic)