The Role of Antibiotic Prophylaxis in the Ureteroscopy Treatment for Ureteral Lithiasis

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Abstract

Introduction: One of the most common pathologies in urological praxis is urinary lithiasis. Extracorporeal shock wave lithotripsy (ESWL) or frequently retrograde ureteroscopy are modern pathways in the treatment of this kind of pathology. There are certain problems which may develop after the ureteroscopy such as infection with fever complication.

Material and method: This retrospective study evaluates 164 patients who underwent ureteroscopy treatment over a period of two years (2011-2012). We compared the infection complication episode (with fever) in 33 (20.12%) patients with antibiotic prophylaxis (group A) versus 131 (79.87%) patients without prophylaxis (group B). Antibiotics used for prophylaxis were: amoxicilinum and clavulanic acid, generation I and II cephalosporines.

Results: Twenty-four (14.63%) patients presented postsurgical fever. Most febrile patients were those with grade II hydronephrosis - 16 (66.66%), of which 2 (6.06%) patients from group A and 14 (10.68%) from group B. From group A, 3 (12%) patients with stones below 10 mm had fever, while 18 (14.87%) from group B developed this complication. Among the patients with stones’ size over 10 mm, 1 (14.28) patient from group A and 2 (25%) patients from group B had fever.

Conclusions: Patients undergoing the ureteroscopy treatment should be investigated before the procedures for the presence of bacteria in order to avoid complications like infection associated with fever. Antibiotic prophylaxis may reduce the incidence of postoperative infection in the ureteroscopy treatment.

1. Geavlete P. Ureteroscopia. Ed. Univ. „Carol Davila”, 2008, pg. 237-238.

2. EAU Indication for active stone removal and selection of procedure, Guidelines 2013 Edition, pg. 41-43.

3. EAU Perioperative antibacterial prophylaxis in Urology. Guidelines 2014 Edition, pg. 77-92.

4. Geavlete P, Jecu M, Geavlete B, et al: Ureteroscopy - an essential modern approach in upper urinary tract diagnosis and treatment. J Med Life. 2010;3(2):193-199.

5. Geavlete P, Georgescu D, Niţă G, Mirciulescu V, Cauni V. Complications of 2735 Retrograde Semirigid Ureteroscopy Procedures: A Single-Center Experience. Journal of Endourology. 2006;20(3):179-185. doi:10.1089/ end.2006.20.179.

6. Hakim NS, Paplois VE. Surgical complications: Diagnosis and treatment, Imperial College Press. 2007, pg. 587.

7. Merlo F, Cicerello E, Mangano M, Cova G, Maccatrozzo L. Stenting after ureteroscopy for ureteral lithiasis: results of a retrospective study. Arch Ital Urol Androl. 2011;83(1):57-9.

8. Mariappan P, Loong CW. Midstream urine culture and sensitivity test is a poor predictor of infected urine proximal to the obstructing ureteral stone or infected stones: a prospective clinical study. J Urol. 2004;171(6 Pt 1):2142-5.

Acta Medica Marisiensis

The Journal of The University of Medicine and Pharmacy of Targu-Mures

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