Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.12.10 Percutaneous nephrolithotomy (PCNL).
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Dogan
2002
[57]
Turkey
RCT
Percutaneous stone
extration. Sterile urine
pre-PCNL. No ab prior
to operation.
n=81
Follow-up within 24 h
I: Single dose ofloxacin
200 mg iv at anesthesia
induction (n=43)
C: Short term
ofloxacin 400 mg
po until removal
nefrostomy tube
(mean 3 days) (n=38)
Fever
I: 9/43 (21%)
C: 8/38 (21%)
Urine culture positive
(100 000 cfu/mL)
and bacteriemia
from febrile patients
I: 3/9 and 1/9
No indicated
Moderate
No difference between
singel dose and
prolonged ABP course
in PCNL. Positive
bacterial growth in
23% of stones despite
negative urine culture
Fourcade
1990
[54]
France
RCT
Uretero-renoscopy for
kidney stone treatment.
Sterile urine and no ab
prior to operation.
n=71
Follow-up within first
3 days
I: Single dose cefotaxime
1 g iv (n=33)
C: Placebo (n=38) BU >100 000 cfu/mL
I: 2/32 (6%)
C: 8/38 (21%)
Fever
I, C: Fever not separetly
reported per
type of operation
Not indicated
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
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
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