[Use of levofloxacin in transcutaneous nephrolithotripsy].
The aim of the study was elucidation of levofloxacin (tavanik) efficacy in transcutaneous nephrolithotripsy (TNLT) made to prevent or treat infectious-inflammatory complications. We performed 211 transcutaneous endoscopic operations on the kidneys for urolithiasis (71 males and 117 females). Of them, 47 (25%) patients received tavanik. The concrement was located in the pelvis (n=9), calyx (n=9), pelvoureteral segment (n=5). Coral concrements were found in 24 cases (K1--in 12, K2--in 6, K3--in 3, K4--in 3 patients). Nephrolitholapaxy was performed in 39 patients, nephrolithoextraction--in 8 patients. Duplex ultrasound dopplerography conducted in all the examinees before surgery and on day 5-6 after it gave information about renal blood flow. Duration of the operation varied from 20 minutes in nephrolithoextraction to 136 minutes in nephrolitholapaxy of the coral concrements (mean time 40 +/- 6 min). Tavanik' was given according to the following scheme: 24 hours before the operation 500 mg tavanik was given orally, on the day of surgery and 3 consequent days 500 mg intravenously dropwise, the next 4 days 500 mg orally. Thus, a course of tavanik lasted 8 days. Nephroliths were removed in all the patients. Mean hospital stay was 7 days. In the group of 47 patients intraoperative complications were not observed. Pelvic microperforation (1 case) and loss of the concrement fragment in the paranephria (1 case) were not considered as complications and had no effect on postoperative period and recovery of the patient. Postoperative complications occurred in 6 (12.7%) patients: late hemorrhage (1), pyelonephritis (4), bacteriotoxic shock early after surgery (1). Thus, postoperative infectious-inflammatory complications arose in 5 (10.63%) patients. These patients received the same antibacterial treatment as the other patients except one patient with bacteriotoxic shock in whom a daily dose of tavanik was raised to 1 g in the course of 2 days. As success of transcutaneous nephrolithotripsy depends much on adequate pre- and postoperative antibacterial therapy, tavanik (levofloxacin) can be effectively used as monotherapy in transcutaneous nephrolithotripsy to prevent and treat postoperative infectious-inflammatory complications.
Zhuravlev
V N
VN
Frank
M A
MA
Sanzharov
A E
AE
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control; D007669:Kidney Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D007902:Length of Stay; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D015242:Ofloxacin / Q000008:administration & dosage*; D014463:Ultrasonography
D000892:Anti-Infective Agents, Urinary; D064704:Levofloxacin; D015242:Ofloxacin