Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: Evidence from a randomised controlled trial

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dc.authorid0000-0002-6308-1763
dc.authorid0000-0003-0906-4417
dc.contributor.authorZhao, Zhijian
dc.contributor.authorFan, Junhong
dc.contributor.authorSun, Hongling
dc.contributor.authorZhong, Wen
dc.contributor.authorZhu, Wei
dc.contributor.authorLiu, Yongda
dc.contributor.authorWu, Wenqi
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authordel Pilar Laguna Pes, Maria
dc.contributor.authorZeng, Guohua
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:36:20Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:36:20Z
dc.date.issued2019
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractObjective: To study the incidence of postoperative systemic inflammatory response syndrome (SIRS) following different antibiotic prophylaxis (ABP) regimens in retrograde intrarenal surgery (RIRS). Patients and Methods: Single-centre, randomised, controlled trial (August 2014–September 2017) including 426 patients with renal stones with preoperative sterile urine managed by RIRS (ClinicalTrials.gov NCT02304822). Different ciprofloxacin-based ABP regimens were used and included a zero dose, single dose (30 min before surgery) or two doses (first dose at 30 min before RIRS and additional dose within 6 h after RIRS). The incidence of SIRS was compared using intention-to-treat (ITT) and per-protocol (PP) analyses. Results: Each group enrolled 142 patients. In the ITT analysis, a zero dose of ABP was statistically similar to the two ABP regimes for the incidence of SIRS (9.9% vs single dose 4.9%, P = 0.112; vs two doses 4.2%, P = 0.062). There were also no relevant differences across groups in the PP analysis; no urosepsis was recorded. In subgroup analysis with stratification by stone area, the three regimens all had a low and similar incidence of SIRS for stones of ?200 mm2 in the ITT analysis with a sufficient power value (5.4% vs 6.2% vs 3.6%, P = 0.945 vs single dose and P = 0.553 vs two doses). However, there was a greater chance of SIRS in patients who received no ABP with stones of >200 mm2 (18% vs single dose 4.3%, P = 0.036; vs two doses 5.5%, P = 0.044). Similar trends were seen in the PP analysis. Conclusions: For patients with preoperative sterile urine, ABP is not strongly recommended in patients with stones of ?200 mm2, but for stones >200 mm2 single-dose ABP is still required.
dc.identifier.citationZhao, Z., Fan, J., Sun, H., Zhong, W., Zhu, W., Liu, Y. … Zeng, G. (2019). Recommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: Evidence from a randomised controlled trial. BJU International, 124(3), 496-503. https://dx.doi.org/10.1111/bju.14832
dc.identifier.doi10.1111/bju.14832
dc.identifier.endpage503
dc.identifier.issn1464-4096
dc.identifier.issn1464-410X
dc.identifier.issue3
dc.identifier.scopusqualityQ1
dc.identifier.startpage496
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1135
dc.identifier.urihttps://dx.doi.org/10.1111/bju.14832
dc.identifier.volume124
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBlackwell Publishing Ltd
dc.relation.ispartofBJU Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectKidney Stones
dc.subjectUro Stone
dc.subjectAntibiotic Prophylaxis
dc.subjectInfectious Complications
dc.subjectRenal Stones
dc.subjectRetrograde Intrarenal Surgery
dc.titleRecommended antibiotic prophylaxis regimen in retrograde intrarenal surgery: Evidence from a randomised controlled trial
dc.typeArticle

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