title: Prevention of infectious complication and its risk factors after urological procedures of the upper urinary tract.
abstract: BACKGROUND
  Invasive upper urinary tract procedures such as retrograde pyelography (RP) or single (S-J) or double J (D-J) stenting are commonly performed to assess or treat ureteral strictures. Urinary tract infection (UTI) can result after such procedures, and prophylactic antimicrobial administration (PAA) may be necessary. This study investigated infectious complications and risk factors, focusing on PAA.
  
  
  METHODS
  We studied antimicrobial prevention in 353 upper urinary tract examinations or treatments. Procedures included S-J or D-J installation or exchange, RP and percutaneous nephrostomy. We investigated PAA and the occurrence of febrile infectious complications with respect to each procedure and attempted to find the risk factors.
  
  
  RESULTS
  Levofloxacin was used in 149 subjects (42.2%) and cefcapene pivoxil in 114 cases (32.3%). There were 16 febrile infectious complication cases (4.5%) after procedures, and pyuria or hydronephrosis prior to examination or treatment was an independent risk factor for infectious complication (p < 0.05) as well.
  
  
  CONCLUSIONS
  These data showed that it is necessary to evaluate the risk factors before urological procedures of the upper urinary tract and to offer a definite preventive methodology according to these risk factors for the establishment and update of guidelines.
authors: Department of Surgery, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Minori
authors: M
authors: Matsumoto
authors: Katsumi
authors: K
authors: Shigemura
authors: Fukashi
authors: F
authors: Yamamichi
authors: Kazushi
authors: K
authors: Tanaka
authors: Yuzo
authors: Y
authors: Nakano
authors: Soichi
authors: S
authors: Arakawa
authors: Masato
authors: M
authors: Fujisawa
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents