TY - JOUR
T1 - Antibiotic prophylaxis in flexible ureterorenoscopy with negative urine culture
AU - Méndez-Guerrero, Daniela María
AU - Buitrago-Carrascal, Christian
AU - Puentes-Bernal, Andrés Felipe
AU - Cruz-Arévalo, Dilma Alexandra
AU - Camacho-Nieto, Diego
AU - Calderón, Marcelo Andrés
AU - Álvarez-Restrepo, Juan Camilo
AU - Brijaldo-Carvajal, Mayra Alejandra
AU - Perdomo-Bernal, Natalia
AU - Moreno-Matson, María Carolina
AU - Ibañez-Pinilla, Milciades
AU - Daza-Vergara, José
N1 - © 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.
PY - 2023/11
Y1 - 2023/11
N2 - OBJECTIVE: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).METHODOLOGY: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.RESULTS: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37,
p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59,
p = 0.009).
CONCLUSIONS: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.
AB - OBJECTIVE: To improve susceptibility profiles of nosocomial bacteria, identifying the difference between infectious complications in patients undergoing endoscopic flexible ureterolithotomy (fURS) with negative urine culture (UC) that received extended antibiotic prophylaxis (EP) compared with standard antibiotic prophylaxis (SP).METHODOLOGY: This is a retrospective, observational, analytical cohort study, comparing infectious complications between patients undergoing fURS with negative UC who received EP versus SP. We include patients with susccessfull fURS, <20-mm stones and complete information.RESULTS: Overall, 10.3% of patients had complications, 7.2% of patients had postoperative urinary infection, 1.8% had upper urinary tract infection (UTI) and 1.4% had urinary sepsis. Lower UTI were significantly more likely in the extended prophylaxis group with 6.8% versus 2.7% (RR = 2.8; 95% CI: 1.10-7.37,
p = 0.030). The risk of upper UTI and sepsis did not show significant differences. A total of 69% patients with postoperative infection had isolated multidrug-resistant bacteria (MDRB) in the UC, with a higher risk in patients with extended prophylaxis (RR = 3.1; 95% CI: 1.33-7.59,
p = 0.009).
CONCLUSIONS: Patients with negative UC who underwent fURS using extended prophylaxis have two times higher risk of low UTI than patients with standard prophylaxis, without differences in the incidence of upper UTI or urinary sepsis. The risk of MDRB isolation in the postoperative UC is higher in the extended prophylaxis group, therefore we recommend the standard 60-min preoperative prophylaxis.
U2 - 10.1002/bco2.242
DO - 10.1002/bco2.242
M3 - Artículo
C2 - 37818028
SN - 2688-4526
VL - 4
SP - 688
EP - 694
JO - BJUI compass
JF - BJUI compass
IS - 6
ER -