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Antibiotic prophylaxis for percutaneous nephrolithotomy: An updated systematic review and meta-analysis

Authors
 Hae Do Jung  ;  Kang Su Cho  ;  Young Joon Moon  ;  Doo Yong Chung  ;  Dong Hyuk Kang  ;  Joo Yong Lee 
Citation
 PLOS ONE, Vol.17(4) : e0267233, 2022-04 
Journal Title
PLOS ONE
Issue Date
2022-04
MeSH
Anti-Bacterial Agents / therapeutic use ; Antibiotic Prophylaxis / methods ; Female ; Humans ; Kidney Calculi* / etiology ; Male ; Nephrolithotomy, Percutaneous* / adverse effects ; Postoperative Complications / etiology ; Systemic Inflammatory Response Syndrome / drug therapy ; Systemic Inflammatory Response Syndrome / etiology ; Systemic Inflammatory Response Syndrome / prevention & control
Abstract
Introduction: A single dose of preventive antibiotics is known to be sufficient to reduce the rate of infection-related complications in percutaneous nephrolithotomy (PCNL). However, some studies reported that the extended dose showed lower complications for high-risk groups. Therefore, we performed a systematic review and meta-analysis comparing single- and extended-dose antibiotic prophylaxis for PCNL.

Materials and methods: Relevant studies that compared single- and extended-dose antibiotic prophylactic therapies were identified. Articles were selected from PubMed, EMBASE, KoreaMed, and Google Scholar up to September 2021. Fever and systemic inflammatory response syndrome (SIRS) were compared by meta-analysis. A subgroup analysis was performed according to the degree of risk to the patient.

Results: A total of 10 articles were included in this study. There were no significant differences between single dose and extended dose in the rate of fever [p = 0.93, OR = 0.96, 95% confidence interval (CI) 0.44-2.13, I2 = 64%]. Extended dose showed lower rate of SIRS compared to single dose (p = 0.0005, OR = 1.81, 95% CI 1.30-2.53, I2 = 53%); in the subgroup analysis, extended dose also showed lower rates of SIRS compared to single dose in high-risk patients (p <0.0001, OR = 3.53, 95% CI 1.91-6.54, I2 = 36%).

Conclusions: The results of our meta-analysis showed that single-dose antibiotic prophylaxis can be effective for PCNL, but extended-dose antibiotics can be required in high-risk patients to reduce post-PCNL infection-related complications.
Files in This Item:
T202201479.pdf Download
DOI
10.1371/journal.pone.0267233
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Dong Hyuk(강동혁)
Moon, Young Joon(문영준)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Chung, Doo Yong(정두용)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188553
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