title: Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients.
abstract: OBJECTIVE
  To compare single-dose and short-course antibiotic prophylaxis protocols in percutaneous nephrolithotomy.
  
  
  METHODS
  Eighty-one patients with sterile urine preoperatively who underwent percutaneous nephrolithotomy were divided into two groups. The first group (N = 43) received a single intravenous dose of antibiotic (200 mg of ofloxacin) during anesthetic induction, and the second group (N = 38) received treatment doses of antibiotic (400 mg of ofloxacin per day) until the nephrostomy catheter was removed. The two groups were identical according to demographic and treatment characteristics. For each patient, microbiologic evaluation of extracted stones and urine samples was done. If patients developed fever in the postoperative period, blood and urine cultures were taken. Factors that might have affected the development of postoperative fever and infection were analyzed.
  
  
  RESULTS
  Nine patients in the first group had postoperative fever. Three had bacteriuria, and one had bacteremia. In the second group, eight patients had fever. One had bacteriuria and bacteremia. Nineteen patients (eleven in the first group, eight in the second) had positive stone cultures. No statistical difference was observed between the two groups in terms of bacteriuria, bacteremia, positive stone cultures, or postoperative fever. The febrile patients had longer operations with the use of more irrigation fluid and longer postoperative hospital stays.
  
  
  CONCLUSIONS
  In patients whose preoperative urine cultures are sterile, short-term prophylaxis has no advantage over single-dose prophylaxis as a means of preventing infection. The duration of surgery and the amount of irrigation fluid are significant risk factors for postoperative fever.
authors.affiliation: Department of Urology, Section of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: H Serkan
authors.initials: HS
authors.lastname: Doğan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahin
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Cetinkaya
authors.forename: Bülent
authors.initials: B
authors.lastname: Akdoğan
authors.forename: Ender
authors.initials: E
authors.lastname: Ozden
authors.forename: Sezer
authors.initials: S
authors.lastname: Kendi
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001437:Bacteriuria / Q000382:microbiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D015242:Ofloxacin / Q000008:administration & dosage*; D011183:Postoperative Complications; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D016482:Urinalysis
chemical_list: D015242:Ofloxacin