Antibiotic Prophylaxis for Shock Wave Lithotripsy in Patients with Sterile Urine Before Treatment May be Unnecessary: A Systematic Review and Meta-Analysis

Yang, Lu; Fan, Tianyong; Han, Ping; Liu, Liangren; Yuan, Haichao; Wang, Qiang

doi:10.1016/j.juro.2012.04.014

Cited by 41 publications

(21 citation statements)

References 24 publications

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“…However, control of bacteriuria and prophylaxis is recommended in cases of internal stent and treatment, due to the increased bacterial burden (e.g. indwelling catheter, nephrostomy tube, or infectious stones) [361][362][363][364][365][366][367][368][369][370] (LE: 1a-1b, GR: A) (Table 23).…”

Section: N425 Shock-wave Lithotripsymentioning

confidence: 99%

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Amaral

Pereira

Rodrigues

et al. 2019

Porto Biomedical Journal

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Background: Urinary tract infection (UTI) is a common complication of spinal cord injury (SCI). Urodynamic testing is widely used for characterization of vesico-sphincteric dysfunction and for therapeutic orientation. As an invasive procedure, the risk of UTI is increased so, in some medical centers, antibiotic prophylaxis is instituted. Fosfomycin is one of the antibiotics used. Objective: The aim of this study was to evaluate the incidence of UTI after urodynamics in patients with SCI, under fosfomycin prophylaxis. Methods: Retrospective analysis was performed on patients with SCI, admitted to a rehabilitation center between January 2016 and June 2017, who underwent urodynamics studies under fosfomycin prophylaxis. Demographic data, risk factors for UTI—bacteriuria before urodynamics, high residual volume (>100 mL), bladder emptying method, vesico-sphincteric dyssynergia, and detrusor hyperactivity were analyzed. The incidence of UTI after urodynamics was evaluated. Results: The study included 84 patients, predominantly men 55 (65.5%). The mean age of the patients was 55.6 (18.9). Eleven (22.5%) had vesico-sphincteric dyssynergia, 32 (65.3%) detrusor hyperactivity and 22 (44.9%) had a high residual volume. Thirty-seven (44.1%) had asymptomatic bacteriuria before the urodynamics. Urinary complaints suggestive of UTI after urodynamics were observed in 2(2.4%) of patients, without significant bacteriuria and identification of bacterial agent. Conclusions: The incidence of UTI after invasive procedures is reported between 3% and 20% in the literature, so antibiotic prophylaxis has been instituted, although controversial. In the study, in none of the patients the diagnosis of UTI was confirmed. Fosfomycin prophylaxis may have been important in reducing the incidence of UTI.

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Section: N425 Shock-wave Lithotripsymentioning

confidence: 99%

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Amaral

Pereira

Rodrigues

et al. 2019

Porto Biomedical Journal

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“…However, control of bacteriuria and AMP is recommended in cases of increased bacterial burden (e.g. indwelling catheter, nephrostomy tube, or infectious stones) [331][332][333][334][335][336][337][338][339][340].…”

Section: Shock-wave Lithotripsymentioning

confidence: 99%

Experimental modeling of bacterial prostatitis. Review

Kogan¹,

Naboka²,

Ismailov³

et al. 2019

ECU

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Different classification systems of UTI exist. Most widely used are those developed by the Centers for Disease Control and Prevention (CDC) [6], Infectious Diseases Society of America (IDSA) [7], European Society of Clinical Microbiology and Infectious Diseases (ESCMID) [8] as well as the U.S. Food and Drug Administration (FDA) [9, 10]. Current UTI guidelines frequently use the concept of uncomplicated and complicated UTI with a number of modifications (Figure 1). In 2011 the EAU/EAU Section of Infections in Urology proposed the ORENUC classification system based on the clinical presentation of the UTI, categorisation of risk factors and availability of appropriate antimicrobial therapy [11]. Figure 1-Concept of uncomplicated and complicated UTI The following classification of UTIs is adopted in the EAU Urological Infections Guidelines: Classification of UTI Uncomplicated UTIs Acute, sporadic or recurrent lower (uncomplicated cystitis) and/or upper (uncomplicated pyelonephritis) UTI, limited to non-pregnant, premenopausal women with no known anatomical and functional abnormalities within the urinary tract or comorbidities. Complicated UTIs All UTIs which are not defined as uncomplicated. Meaning in a narrower sense UTIs in a patient with an increased chance of a complicated course: i.e. all men, pregnant women, patients with anatomical or functional abnormalities of the urinary tract, indwelling urinary catheters, renal diseases, and/or with other concomitant immunocompromising diseases for example, diabetes. Recurrent UTIs Recurrences of uncomplicated and/or complicated UTIs, with a frequency of at least three UTIs/year or two UTIs in the last six months. Catheter-associated UTIs Catheter-associated urinary tract infection (CA-UTI) refers to UTIs occurring in a person whose urinary tract is currently catheterised or has been catheterised within the past 48 hours. Urosepsis A systemic, deleterious host response to infection originating from the urinary tract and/or male genital organs. Urosepsis is accompanied by signs of systemic inflammation, presence of symptoms of organ dysfunction and persistent hypotension associated with tissue anoxia. 3.2 Antimicrobial stewardship Antimicrobial stewardship programmes aim to optimise the outcome of prevention and treatment of infection whilst curbing overuse and misuse of antimicrobial agents [12-16]. Measures of success include regulating antimicrobial prescribing, and reduction in both the rate of healthcare associated infections such as Clostridium difficile and the emergence of resistant organisms [16]. In urology, antimicrobial stewardship programmes should include a series of measures to ensure rational, evidence based use of antimicrobials in the prevention and treatment of infections of the urinary tract and male accessory glands, as well as non-antimicrobial strategies. Programmes require a stewardship team approach comprising urologists, infectious diseases Cystitis Pyelonephritis Recurrent UTI Catheter-associated UTI Urosepsis Complicated UTI Uncomplicated UTI U...

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“…Antimicrobial prophylaxis is not recommended as a standard application in extracorporeal shock wave lithotripsy (35). However, it is indicated to use prophylaxis for the control of bacteriuria and in elevated bacterial load, such as permanent catheter, nephrostomy tube, or presence of infective stones (44).…”

Section: • Extracorporeal Shock Wave Lithotripsymentioning

confidence: 99%

Current Approaches to Surgical Antimicrobial Prophylaxis and Use of Antimicrobial Prophylaxis in Urological Procedures

Şen¹,

Demırdal²

2017

jus

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Cite this article as: Şen P, Demirdal T. Current Approaches to Surgical Antimicrobial Prophylaxis and Use of Antimicrobial Prophylaxis in Urological Procedures. J Urol Surg 2017;4:159-166. Surgical site infections (SSIs) are the most common and preventable type of healthcare-associated infections in low and middle-income countries and affect one-third of patients that have undergone surgical procedures. As the number of surgical procedures performed increases, the prevention of SSIs becomes more important. It is considered that, it is possible to prevent approximately half of all SSI cases. However, due to the contribution of many factors to the development of SSIs, it may be difficult to effectively prevent these infections, and there is a need to take various preventive measures before, during and after surgery. This review presents the current recommendations on the use of prophylactic antimicrobial agents for the prevention of SSIs and recommendations about antimicrobial prophylaxis in urological procedures.Cerrahi alan enfeksiyonları (CAE) en sık görülen sağlık bakımıyla ilişkili enfeksiyonlar olup önlenebilir olması nedeniyle önem arz etmektedir. CAE önlenmesi için uygulama çeşitleri gittikçe artmakta ve buna bağlı olarak kanıta dayalı müdahale talepleri gün geçtikçe artmaktadır. Bu nedenle önceden yayınlanan kılavuzlara ek güncelleme ihtiyacı doğmaktadır. Yeni ve güncellenmiş öneriler sadece sağlık mensupları için değil, aynı zamanda profesyonel dernek ve kuruluşlar için de bir kaynak olabilme özelliğini taşımaktadır. Bu derlemede CAE önlemeye yönelik profilaktik antimikrobiyal ajan kullanımıyla ilgili güncel önerileri sunmak amaçlanmıştır. Abstract ÖzCerrahi Öncesi Profilakside Güncel Yaklaşımlar Işığında Ürolojik Preoperatif Antibiyotik Uygulamaları

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Antibiotic Prophylaxis for Shock Wave Lithotripsy in Patients with Sterile Urine Before Treatment May be Unnecessary: A Systematic Review and Meta-Analysis

Cited by 41 publications

References 24 publications

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Experimental modeling of bacterial prostatitis. Review

Current Approaches to Surgical Antimicrobial Prophylaxis and Use of Antimicrobial Prophylaxis in Urological Procedures

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