Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.12.9 Ureteroscopic stone removal (URS).
Author
Year
Reference
Country
Study
design
Population characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results outcome 1
intervention
Withdrawal
Drop outs
Study quality
and relevance
Comments
Fourcade
1990
[54]
France
RCT
Uretero-renoscopy for kidney
stone treatment. Sterile urine
and no ab prior to operation.
n=71
Results within first 3 days
post URS
I: Single dose cefotaxime
1 gram iv (n=33)
C: Placebo
(n=38)
BU >100 000 cfu/mL
I: 2/32 (6%)
C: 8/38 (21%)
Fever 3 and 30 days
I, C: Fever not separately
reported per
type of operation
Not indicated
per type of
operation
Moderate
Study report on both URS
and PCNL. Overall rate
of fever 20% in placebo
and 15% in cefotaxime
group for URS + PCNL.
Group numbers per type
of operation too small for
significance
Knopf
2003
[55]
Germany
RCT
Undergoing URS.
Negative pre-op urine
culture reported.
n=113
Follow-up within
48 h after URS
I: Single dose levofloxacin
250 mg po 1 h before
operation (n=57). 1 pt
with pre-op positive
urine culture
C: No ab (n=56).
1 pt with pre-op
positive urine
culture
BU
I: 1/57 (1.8%) of
all, 0/56 (0%) of
pre-op negative
urine culture
C: 7/56 (12.5%)
of all. 6/55 (10.7%)
of pre-op negative
urine culture
Not indicated
High
ABP reduce significantly
BU after URS but not
symptomatic, febrile
infections
Symptomatic UTI
or “inflammable”
complication
I: 0/57
C: 0/56
ab = Antibiotic; ABP = Antibiotic prophylaxis; BU = Bacteriuria; C = Control group;
cfu = Colony forming units; h = Hours; I = Intervention group; iv = Intravenous;
n = Number of patients; PCNL = Percutaneous nephrolithotomy; po = Per os; RCT =
Randomised controlled trial; URS = Ureteroscopic stone removal; UTI = Urinary tract
infection
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