Risk adapted strategy for choosing the right drug for antibiotic prophylaxis in percutaneous nephrolithotomy
Kuwait Medical Journal, cilt.55, sa.1, ss.39-44, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 55 Sayı: 1
- Basım Tarihi: 2023
- Dergi Adı: Kuwait Medical Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.39-44
- Anahtar Kelimeler: antibiotic prophylaxis, cefazolin, ceftriaxone, percutaneous nephrolitholithotomy, systemic inflammatory response syndrome
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To create risk groups and compare the effectiveness of ceftriaxone and cefazolin for prophylaxis according to these risk groups Design: Retrospective study Setting: Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, Turkey Subjects: A total of 671 patients who underwent percutaneous nephrolithotomy (PCNL) for renal stones between January 2014 and July 2018 were included in the present retrospective study. Two hundred and twenty-three of the patients were given cefazolin, whereas 448 were given ceftriaxone as antibiotic prophylaxis. High-risk patients were defined as having ≥2 cm stone diameter plus one of the following: operation duration ≥120 min, multiple puncture (≥2), recurrent urinary tract infection history, stone culture positivity or renal pelvic urine culture positivity. All patients were followed up for systemic inflammatory response syndrome (SIRS) criteria postoperatively. Interventions: Percutaneous nephrolithotomy Main outcome measures: SIRS Results: Of all patients, 188 (28%) were in high risk group and 483 (72%) were in low risk group. No statistically significant difference was found between cefazolin and ceftriaxone group for SIRS in all patients and in low-risk group. However, in high-risk group, SIRS rates were significantly higher in cefazolin group compared to ceftriaxone group (P=0.001). Conclusions: A risk adapted approach is important for selecting the type of antibiotic for prophylaxis in PCNL. In the present study, we found that ceftriaxone is superior to cefazolin in terms of post PCNL SIRS only in high-risk patients.