title: A Single Dose of Intraoperative Antibiotics Is Sufficient to Prevent Urinary Tract Infection During Ureteroscopy.
abstract: BACKGROUND
  American Urology Association (AUA) Best Practice Guidelines for ureteroscopic stone treatment recommend antibiotic coverage for <24 hours following the procedure. The purpose of this study was to evaluate if the addition of postoperative antibiotics reduces urinary tract infections (UTIs) following ureteroscopic stone treatment beyond the recommended preoperative dose.
  
  
  METHODS
  A retrospective review was performed of consecutive patients at two institutions, University of British Columbia and Massachusetts General Hospital, Harvard. All patients received a single dose of antibiotics before ureteroscopic stone treatment. A subset of patients was also given postoperative antibiotics. The rate of UTI was compared in patients receiving only preoperative antibiotics (group 1) vs those who received pre- and postoperative antibiotics (group 2).
  
  
  RESULTS
  Eighty-one patients underwent ureteroscopy for renal calculi. Mean time to follow up was 42 ± 88 days. Eight (9.9%) patients in total (two from group 1 and six from group 2, p = 0.1457) developed UTIs postoperatively. In group 1, both patients presented with pyelonephritis (n = 2); those patients with infections in group 2 presented with urosepsis (n = 2) and cystitis (n = 2) and two patients had asymptomatic bacteriuria. Risk factors such as preoperative stenting, nephrostomy tubes, and foley catheters neither differed between groups nor did they predispose patients to postoperative infections.
  
  
  CONCLUSIONS
  The postoperative UTI rate in this study (9.9%) is consistent with previous reports. Our data suggest that a single preoperative dose of antibiotics is sufficient, and additional postoperative antibiotics do not decrease infection rates after ureteroscopic stone treatment. Risk for selection bias is a potential limitation.
authors.affiliation: 1 University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Ben H
authors.initials: BH
authors.lastname: Chew
authors.affiliation: 1 University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Ryan
authors.initials: R
authors.lastname: Flannigan
authors.affiliation: 2 Department of Urology, Massachusetts General Hospital, Harvard Medical School.
authors.forename: Michael
authors.initials: M
authors.lastname: Kurtz
authors.affiliation: 2 Department of Urology, Massachusetts General Hospital, Harvard Medical School.
authors.forename: Boris
authors.initials: B
authors.lastname: Gershman
authors.affiliation: 1 University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Olga
authors.initials: O
authors.lastname: Arsovska
authors.affiliation: 1 University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Ryan F
authors.initials: RF
authors.lastname: Paterson
authors.affiliation: 2 Department of Urology, Massachusetts General Hospital, Harvard Medical School.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Eisner
authors.affiliation: 1 University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Dirk
authors.initials: D
authors.lastname: Lange
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007669:Kidney Calculi / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000517:prevention & control*; D015607:Stents; D018666:Ureteroscopy / Q000379:methods*; D014552:Urinary Tract Infections / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents