A comparative study between a single dose pre-induction antibiotic versus continuous antibiotics to prevent urinary tract infection during ureteroscopy

摘要

Background and objective: This study aimed to evaluate the effect of addingpostoperative antibiotics in reducing the incidence of symptomatic urinary tract infectionsfollowing ureteroscopic stone treatment beyond the recommended preoperative dose.Methods: This prospective comparative study was conducted between March andNovember 2017. A total of 80 patients with preoperative negative urine cultures whounderwent ureteroscopy were randomly allocated. All the patients received a single doseantibiotic before the induction of anesthesia, and a group of them also receivedpostoperative antibiotics. The rate of symptomatic urinary tract infection was comparedbetween the patients who received only preoperative antibiotics (group 1) and those whoreceived pre- and postoperative antibiotics (group 2).Results: Eighty patients underwent ureteroscopy for stone treatment. The time to follow upwas 4±2 weeks from ureteroscopy. Eleven (13.8%) patients in total developed urinary tractinfections postoperatively, including five (12.5%) from group 1 and six (15%) from group 2,P = 0.74. In group 1, four patients presented with cystitis and one with sepsis; thosepatients with infections in group 2 presented with pyelonephritis (n=2) and cystitis (n=4).Risk factors such as preoperative stenting, nephrostomy tubes, and Foleys cathetersdid not differ between groups.Conclusion: The postoperative symptomatic urinary tract infection rate in this study(13.8%) is in agreement with previous reports. This study suggests that a singlepreoperative dose of antibiotics is sufficient, and additional postoperative antibiotics do notdecrease infection rates after ureteroscopic stone treatment.