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Randomized comparison of effect of standard antibiotic prophylaxis versus enhanced prophylactic measures on rate of urinary tract infection after flexible ureteroscopy

Authors

El-Sayed I. El-Agamy
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo; Department of Urology, Armed Forced Hospital, Alhada, KSA, Egypt.
Mohamed A. Elhelaly
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo; Department of Urology, Armed Forced Hospital, Alhada, KSA, Egypt.
Tamer A. Abouelgreed
dr_tamer_ali@yahoo.com
https://orcid.org/0000-0003-2640-3425
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo; Gulf Medical University, UAE, Egypt.
Abdrabuh M. Abdrabuh
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed F. Elebiary
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Adel Elatreisy
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Osama M. Ghoneimy
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Basem A. Fathi
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Zamra
Department of Urology, AlQasemi Hospital, Sharjah, United Arab Emirates.
Khalid Kutub
Department of Urology, Al Aharq Jospital, Fujairah, United Arab Emirates.

Purpose: To compare the rate of post-flexible ureteroscopy urinary tract infection (UTI) in patients subjected to the standard antibiotic prophylaxis alone versus enhanced prophylactic measures.

Methods: A prospective randomized controlled study included 256 patients subjected to flexible ureteroscopy (FURS) for ureteral or renal stones from March 2018 to July 2022. Treatment groups included the standard antibiotic prophylaxis group (group 1, n=128) and the enhanced prophylaxis group (group 2, n=128). Patients in group 1 were injected with intravenous fluoroquinolone one hour preoperatively, and oral antibiotics were used for 24 h postoperatively. Patients in group 2 had urine culture ten days before the procedure; antibiotic-culture based was given for positive asymptomatic cases, while the procedure was deferred for active UTI.

Results: The study groups were comparable regarding patient demographics, stone characteristics, operative time, and intraoperative complications. The overall hospitalization time was 1.68 ± 0.81 days. Postoperative, and overall complications were significantly higher in group 1 (15.6% vs. 6.3%, p = 0.04 and 26.6% vs. 17.2%, p = 0.047), respectively. Twenty patients (15.6 %) in the standard prophylaxis group were diagnosed with UTI in comparison to 8 patients (6.3 %) in the enhanced prophylaxis group (p = 0.047).

Conclusions: Urinary tract infection after FURS could be reduced significantly by utilizing the suggested enhanced prophylactic approach.

 

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How to Cite

El-Agamy, E.-S. I., Elhelaly, M. A., Abouelgreed, T. A., Abdrabuh, A. M., Elebiary, M. F., Elatreisy, A., Ghoneimy, O. M., Fathi, B. A., Zamra, M., & Kutub, K. (2023). Randomized comparison of effect of standard antibiotic prophylaxis versus enhanced prophylactic measures on rate of urinary tract infection after flexible ureteroscopy. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11084
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