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• W2000364036 abstract "No AccessJournal of UrologyAdult Urology1 Dec 2014Extended Antimicrobial Use in Patients Undergoing Percutaneous Nephrolithotomy and Associated Antibiotic Related Complications Boyd R. Viers, Patrick A. Cockerill, Ramila A. Mehta, Eric J. Bergstralh, and Amy E. Krambeck Boyd R. ViersBoyd R. Viers More articles by this author , Patrick A. CockerillPatrick A. Cockerill More articles by this author , Ramila A. MehtaRamila A. Mehta More articles by this author , Eric J. BergstralhEric J. Bergstralh More articles by this author , and Amy E. KrambeckAmy E. Krambeck Financial interest and/or other relationship with Histosonics. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.06.090AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Despite global concern about antibiotic related complications the duration of antibiotic therapy at percutaneous nephrolithotomy varies based on individual physician practice. We evaluated perioperative antibiotic related complications in patients who received extended antimicrobial therapy at percutaneous nephrolithotomy. Materials and Methods: We reviewed the records of 227 consecutive patients treated with percutaneous nephrolithotomy from 2009 to 2013. Patients with positive urine or stone cultures received extended antimicrobial treatment. All others received 7 days of empirical therapy preoperatively and postoperatively. Adverse antibiotic related events were recorded for up to 3 months. Results: The median duration of antibiotic therapy was 14 days (IQR 14–34). Perioperatively 143 (63%), 67 (30%), 75 (33%) and 41 patients (18%) received nitrofurantoin, trimethoprim/sulfamethoxazole, fluoroquinolones and other antibiotics, respectively. Antibiotic related complications developed in 23 patients (10%) at a median of 12 days (IQR 8–19). Common complications included rash in 7 cases (3%), gastrointestinal upset in 6 (3%) and Clostridium difficile colitis in 1 (0.4%). Trimethoprim/sulfamethoxazole was associated with an increased likelihood of an adverse event (p = 0.04) but patient age, gender, and therapy type (therapeutic vs prophylactic) and duration were not. Finally, antibiotic and multidrug resistance developed in 4 (36%) and 3 patients (27%), respectively, who experienced a urinary tract infection. Conclusions: We report a low rate of adverse antibiotic related events in patients treated with percutaneous nephrolithotomy who received extended perioperative antibiotic therapy. Exposure to trimethoprim/sulfamethoxazole was the only identifiable risk factor for a complication. These findings should be considered when counseling patients on the risks of perioperative antimicrobial therapy at percutaneous nephrolithotomy. References 1 : Percutaneous nephrolithotomy use is increasing in the United States: an analysis of trends and complications. J Endourol2013; 27: 979. Google Scholar 2 : Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol2005; 173: 1610. Link, Google Scholar 3 : A clinical study of upper urinary tract calculi treated with extracorporeal shock wave lithotripsy: association with bacteriuria before treatment. Urol Int1995; 54: 214. 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Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySur R, Krambeck A, Large T, Bechis S, Friedlander D, Monga M, Hsi R, Miller N, Chew B, Lange D, Knudsen B, Sourial M, Humphreys M, Stern K, Shah O, Abbott J and Abedi G (2020) A Randomized Controlled Trial of Preoperative Prophylactic Antibiotics for Percutaneous Nephrolithotomy in Moderate to High Infectious Risk Population: A Report from the EDGE ConsortiumJournal of Urology, VOL. 205, NO. 5, (1379-1386), Online publication date: 1-May-2021.Chew B, Miller N, Abbott J, Lange D, Humphreys M, Pais V, Monga M, Krambeck A and Sur R (2018) A Randomized Controlled Trial of Preoperative Prophylactic Antibiotics Prior to Percutaneous Nephrolithotomy in a Low Infectious Risk Population: A Report from the EDGE ConsortiumJournal of Urology, VOL. 200, NO. 4, (801-808), Online publication date: 1-Oct-2018.Paonessa J, Gnessin E, Bhojani N, Williams J and Lingeman J (2016) Preoperative Bladder Urine Culture as a Predictor of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone CompositionJournal of Urology, VOL. 196, NO. 3, (769-774), Online publication date: 1-Sep-2016.Assimos D (2015) Re: Paraplegia-Quadriplegia Independently Increases all Percutaneous Nephrolithotomy Complications: A Comparative Study Using the Modified Clavien SystemJournal of Urology, VOL. 194, NO. 4, (1017-1017), Online publication date: 1-Oct-2015. Volume 192Issue 6December 2014Page: 1667-1672Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsnephrostomycomplicationsantibiotic prophylaxistrimethoprim-sulfamethoxazole combinationpercutaneouskidneyMetricsAuthor Information Boyd R. Viers More articles by this author Patrick A. Cockerill More articles by this author Ramila A. Mehta More articles by this author Eric J. Bergstralh More articles by this author Amy E. Krambeck Financial interest and/or other relationship with Histosonics. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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