You have accessJournal of UrologyCME1 Apr 2023PD34-11 ONE WEEK PREOPERATIVE ORAL ANTIBIOTICS FOR PERCUTANEOUS NEPHROLITHOTOMY REDUCE RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS Alexandre Danilovic, Thalita Talizin, Fabio Torricelli, Giovanni Marchini, Carlos Batagello, Fabio Vicentini, William Nahas, and Eduardo Mazzucchi Alexandre DanilovicAlexandre Danilovic More articles by this author , Thalita TalizinThalita Talizin More articles by this author , Fabio TorricelliFabio Torricelli More articles by this author , Giovanni MarchiniGiovanni Marchini More articles by this author , Carlos BatagelloCarlos Batagello More articles by this author , Fabio VicentiniFabio Vicentini More articles by this author , William NahasWilliam Nahas More articles by this author , and Eduardo MazzucchiEduardo Mazzucchi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003327.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Approximately 0.5% of the patients develop postoperative sepsis after percutaneous nephrolithotomy (PCNL). The aim of this study is to perform a high quality meta-analysis using only prospective studies to define the role of preoperative antibiotics in patients undergoing PCNL. METHODS: This review was conducted according to PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. We selected prospective studies and randomized controlled trials that compared extended to short dose preoperative antibiotic prophylaxis in patients undergoing PCNL. A search for "percutaneous nephrolithotomy" and "antibiotic" was performed on EMBASE, PubMed and Web Of Science platforms, resulting in 1362 publications. The PICO (population, intervention, control and outcome) was: Population - adult patients that underwent to PCNL; Intervention - extended dose preoperative antibiotic prophylaxis before PCNL; Control - short dose preoperative antibiotic prophylaxis before PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fever after PCNL and positive intraoperative urine culture and stone culture. The meta-analysis protocol was registered on PROSPERO database (CRD42022359589). Alpha risk was defined as <0.05. RESULTS: The final selection was five articles with a total of 475 patients studied. Forest plots (figure 1) evidenced that using antibiotics for 7 days in preoperative period of PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234-0.527, p<0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147–2.388, p=0.462). Patients who received intervention had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120–0.674, p=0.004) and stone culture (OR 0.351, 95% CI 0.185–0.663, p=0.001) than control group. CONCLUSIONS: We conclude that one week of prophylactic oral antibiotics based on local bacterial sensitivity pattern in patients undergoing PCNL reduces the risk of infection. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e924 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandre Danilovic More articles by this author Thalita Talizin More articles by this author Fabio Torricelli More articles by this author Giovanni Marchini More articles by this author Carlos Batagello More articles by this author Fabio Vicentini More articles by this author William Nahas More articles by this author Eduardo Mazzucchi More articles by this author Expand All Advertisement PDF downloadLoading ...