Perioperative antibiotic prophylaxis in ureteroscopic stone removal.
OBJECTIVE
This study shall settle the question whether a perioperative single shot prophylaxis in connection with a ureteroscopic stone removal has an influence on the rate of postoperative urinary tract infections (UTIs) and inflammable complications or not.


METHODS
113 patients were included in this prospective randomized study. In 57 patients 250mg Levofloxacin p. o. was given approximately 60 prior ureteroscopy, 56 patients had no prophylaxis. The evaluation of all data which were processed electronically was carried out with the help of a standardised questionnaire.


RESULTS
Postoperatively symptomatic urinary tract infections or inflammable complications of the urogenital tract were found in neither of the two groups. In the group without prophylaxis, the rate of the postoperative significant bacteriurias was significantly higher than in the group with prophylaxis (7 patients [12.5%] vs. 1 patient [1.8%]) (p=0.026). In six cases there was an E. coli bacteriuria; additionally a Kl. pneumoniae and a not specified Staphylococcus bacteriuria were detected in further cases.


CONCLUSIONS
Single shot prophylaxis using 250 mg Levofloxacin p. o. can be considered as cheap, the patient not burdened and regarding the missed selection pressure to nosocomial pathogens the preferred manner of perioperative antibiotic prophylaxis in ureteroscopic stone removal. In addition perioperative single shot prophylaxis may be beneficial in case of an unexpected intraoperative complication like e.g. ureter perforations.
Knopf
H-J
HJ
Department of Urology, Klinikum Dortmund gGmbH, Teaching Hospital of the University of Munster, Westfalendamm 403, D-44143 Dortmund, Germany. knopfhjwit@t-online.de
Graff
H-J
HJ
Schulze
H
H
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D019990:Perioperative Care; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D014552:Urinary Tract Infections / Q000517:prevention & control
D064704:Levofloxacin; D015242:Ofloxacin