Ciprofloxacin infusion versus third generation cephalosporin as a surgical prophylaxis for percutaneous nephrolithotomy: a randomized study

Abstract

Introduction Percutaneous nephrolithotomy (PCNL) is considered a clean-contaminated surgical procedure. The American Urological Association has recommended different preoperative antimicrobial prophylaxis for various urological procedures to prevent surgical site infections, postoperative fever, and possible sepsis. The European Association of Urology (EAU) antibiotic guidelines endorse giving either a second or third-generation cephalosporin, trimethoprim-sulfamethoxazole, fluoroquinolone or aminopenicillin with a β-lactamase inhibitor. The aim of the present study is to prospectively compare two different protocols of antibiotic prophylaxis in PCNL. Material and methods Successfully consented patients with sterile urine preoperatively who were awaiting percutaneous nephrolithotomy were randomized into two groups. The first group (n = 41) was given a single dose of 200 mg ciprofloxacin infusion, while group two (n = 43) was given 2 mg of cefotaxime divided into 2 doses; during induction of anesthesia and 12 hours later. The occurrence of perioperative infection-related events would be compared in both groups. Results Both groups had similar age, sex, Body Mass Index, and stone composition. No statistical difference was found regarding stone size, stone culture, irrigation fluid volume, operative time and urine pelvis culture result in both groups (Table 2). Two patients (5%) developed postoperative fever in the 1 st group compared to 12 patients (28%) in the second group (p = 0.02). Conclusions A prophylactic regimen consisting of a single dose ciprofloxacin infusion during induction of surgery showed a higher efficacy as a preoperative antibacterial preparation, compared to cefotaxime, in protection against postoperative fever in patients undergoing PCNL.

Recent advancements of miRNAs in the treatment of bone diseases and their delivery potential

“…The miR-410 can stimulate osteogenesis and downregulate osteoclasts' production. With such a regulation, miR-410 can offer an excellent way of treating osteonecrosis ( Omar et al., 2019 ) . Dai et al.…”

Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis

“…A total of 831 studies were identified for potential inclusion in the meta-analysis. After a fulltext review, 10 articles were identified as relevant for this study and selected for inclusion in the meta-analysis (Fig 1) [4,5,[9][10][11][12][13][14][15][16].…”

“…The characteristics of the 10 included studies are shown in Table 1 [4,5,[9][10][11][12][13][14][15][16]. These comparative studies described patients who underwent antibiotic prophylaxis for PCNL for renal stones.…”

“…Three studies were performed in Asia (China, India, and South Korea) [4,11,12], and one study was performed in the U.S [14]. Additionally, one study was conducted in Egypt [13]. Four studies were selected based on the inclusion of a high-risk patient group [4,5,14,16]; six other studies were chosen but did not specify the patient group [9][10][11][12][13]15].…”

“…Additionally, one study was conducted in Egypt [13]. Four studies were selected based on the inclusion of a high-risk patient group [4,5,14,16]; six other studies were chosen but did not specify the patient group [9][10][11][12][13]15]. Four studies were selected based on the use of an "extended preop" [4,5,12,14], whereas six other studies were chosen due to the use of an "extended periop" [9-11, 13, 15, 16].…”