The necessity of prophylactic antibiotics during extracorporeal shock wave lithotripsy

Abstract

In this study we treated 340 patients with renal and ureteric stones. They all underwent ESWL with the HM-4 lithotriptor. The patients were divided into two groups, the first one including 250 patients and the second 90. The first group consisted of patients with sterile urine prior to ESWL. These patients did not receive any antibiotic prophylaxis, while 5.2% of them developed infectious problems which were followed by significant bacteriuria in only 2% of the cases. The 90 patients of the second group had urinary tract infection on the preoperative cultures and received antibiotic treatment. Of these patients 27.8% developed infectious problems which were followed by significant bacteriuria in 21.1% of the cases. Evaluating the above results, we estimate that the administration of prophylactic antibiotics in the case of patients with sterile urine before ESWL is not required while it may prove to be useful in the case of patients with urinary tract infection prior to ESWL.

Antibakterieller Effekt hochenergetischer extrakorporaler Stoßwellen: Ein in vitro Nachweis

“…Die statistische Auswertung erfolgte mittels Mann-Whitney-Test, ein P-Wert < 0,05 wurde als statistisch signifikant gewertet. [10,11]. Im Rahmen der hochenergetischen Stoûwellentherapie zur Behandlung infizierter Pseudarthrosen konnte dies allerdings bislang nicht beobachtet werden [15].…”

Japanese guidelines for prevention of perioperative infections in urological field

“…(2) Incidence of perioperative infections in ESWL [127][128][129][130][131][132][133][134][135][136][137][138][139] The incidences of asymptomatic bacteriuria and symptomatic UTIs after ESWL without preoperative bacteriuria were approximately 10% (ranging from 0 to 24%) and 3% (ranging from 0 to 10%), resp ectively. In addition, the incidence of bacteremia was 0-7.7%, most of which were suspected skin contamination.…”

Antibiotic prophylaxis in urological surgery, a European viewpoint

“…In a few follow-up studies, the frequency of post-ESWL bacteriuria has been shown to be ≤5% in patients without known risk factors [47][48][49]. In only one [50] of five randomized placebo/non-antibiotic-controlled studies was a significant reduction demonstrated [50][51][52][53][54].…”