title: Effectiveness of Prophylactic Antibiotics against Post-Ureteroscopic Lithotripsy Infections: Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the effectiveness of prophylactic antibiotic therapy in reducing the incidence of post-ureteroscopic lithotripsy (URL) infections.
  
  
  METHODS
  A systemic search of PubMED was performed to identify all randomized trials that compared the incidence of post-operative infections in patients without pre-operative urinary tract infections who underwent URL with and without a single dose of prophylactic antibiotics. The data were analyzed using Cochrane Collaboration Review Manager (RevMan, version 5.2). The endpoints of the analysis were pyuria (>10 white blood cells/high-power field), bacteriuria (urine culture with bacteria >10(5) colony-forming units/mL), and febrile urinary tract infections (fUTIs), defined as a body temperature of >38°C with pyuria or meaningful bacteriuria within 1 wk after the operation.
  
  
  RESULTS
  In total, four trials enrolling 500 patients met the inclusion criteria and were subjected to meta-analysis. Prophylactic antibiotics significantly reduced post-URL pyuria (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.51-0.82) and bacteriuria (RR 0.26; 95% CI 0.12-0.60; p=0.001). Patients who received prophylactic antibiotics tended to have lower rates of fUTI, although the difference was not statistically significant.
  
  
  CONCLUSIONS
  Prophylactic antibiotic therapy can reduce the incidence of pyuria and bacteriuria after URL. However, because of the low incidence of post-URL fUTIs, we failed to show that a single dose of prophylactic antibiotics can reduce the rate of such infections significantly.
authors.affiliation: Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, and School of Medicine, Buddhist Tzu Chi University , Hualien, Taiwan .
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Lo
authors.affiliation: Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, and School of Medicine, Buddhist Tzu Chi University , Hualien, Taiwan .
authors.forename: Stephen Shei-Dei
authors.initials: SS
authors.lastname: Yang
authors.affiliation: Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, and School of Medicine, Buddhist Tzu Chi University , Hualien, Taiwan .
authors.forename: Cheng-Hsing
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, and School of Medicine, Buddhist Tzu Chi University , Hualien, Taiwan .
authors.forename: Shang-Jen
authors.initials: SJ
authors.lastname: Chang
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D005334:Fever; D006801:Humans; D015994:Incidence; D008096:Lithotripsy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D018666:Ureteroscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents