title: [Prophylatic antibiotic use in percutaneous nephrolithotomy: a meta-analysis].
abstract: OBJECTIVE
  To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing percutaneous nephrolithotomy (PCNL) who have sterile preoperative urine.
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC and CNKI were searched for RCTs comparing antibiotic prophylaxis with placebo (or blank controls) for patients undergoing PCNL with preoperative sterile urine. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by 2 reviewers using the designed extraction form. The software RevMan 4.2 was used to review management and data analysis.
  
  
  RESULTS
  A total of 9 trails, 1 placebo controlled, 3 non treatment controlled, and 5 active controlled, involving 1018 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing PCNL significantly decreased fever (RR = 0.71, 95% CI: 0.54-0.92, P = 0.009), bacteriuria (RR = 0.39, 95%CI: 0.23-0.67, P = 0.0006) and bacteremia incidence (RR = 0.43, 95%CI: 0.25-0.73, P = 0.002). Effective antibiotic classes included quinolone which significantly decreased bacteriuria incidence (RR = 0.31, 95%CI: 0.12-0.82, P = 0.010) and nitrofurantoin which significantly decreased fever incidence (RR = 0.38, 95%CI: 0.24-0.61, P = 0.005). Extended course significantly decreased fever incidence (RR = 0.64, 95%CI: 0.47-0.87, P = 0.004) and bacteriuria incidence (RR = 0.35, 95%CI: 0.18-0.71, P = 0.003).
  
  
  CONCLUSIONS
  Prophylactic antibiotics can significantly decrease the incidence of postoperative infective complications. A significant decrease in bacteriuria incidence can be achieved with quinolones. Extended course is effective in decreasing fever, and bacteriuria incidence.
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China. Email: yangminggen@163.com.
authors.forename: Ming-gen
authors.initials: MG
authors.lastname: Yang
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
authors.forename: Zhou-da
authors.initials: ZD
authors.lastname: Zheng
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
authors.forename: Zhen-qiang
authors.initials: ZQ
authors.lastname: Xu
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
authors.forename: Hai-li
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
authors.forename: Zhi-ming
authors.initials: ZM
authors.lastname: Zhuang
authors.affiliation: Department of Urology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China.
authors.forename: Chao-xian
authors.initials: CX
authors.lastname: Zhang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001437:Bacteriuria / Q000517:prevention & control*; D006801:Humans; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents