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Shorter Antibiotic Prophylaxis Doesn't Raise Infection Rates

Findings based upon ≤24 hours versus six days of antibiotics with percutaneous nephrolithotomy

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Compliance with American Urological Association (AUA) guidelines for shorter antibiotic prophylaxis does not result in higher rates of infection among patients undergoing percutaneous nephrolithotomy, according to a study published in the October issue of The Journal of Urology.

Sameer Deshmukh, M.D., from Massachusetts General Hospital in Boston, and colleagues retrospectively reviewed the records of consecutive percutaneous nephrolithotomy procedures in patients without a history of urinary tract infection. Patients were grouped based on duration of postoperative antibiotics: group 1: ≤24 hours (52 patients); group 2: mean of six days (30 patients).

The researchers found that fever developed within 72 hours of percutaneous nephrolithotomy in five group-1 patients (9.6 percent), but none demonstrated bacteriuria or bacteremia on cultures. Furthermore, no group-1 patients were treated for urinary tract infection on postoperative days three to 14. In group 2, four patients (13.3 percent) developed fever within 72 hours of percutaneous nephrolithotomy and one patient showed bacteriuria on culture (<10,000 colony-forming units mixed gram-positive bacteria). No group-2 patients demonstrated bacteremia or were treated for urinary tract infection on postoperative days three to 14. Stone-free rates and the need for additional procedures were similar between the two groups.

"In this pilot series, compliance with AUA guidelines for antibiotic prophylaxis did not result in higher rates of infection than in a comparable group of 30 patients who received approximately six days of antibiotics postoperatively," the authors write.

One author disclosed financial ties to the medical device industry.

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