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Incidence of Infectious Complications after Extracorporeal Shock Wave Lithotripsy in Patients Without Associated Risk Factors

2014; Lippincott Williams & Wilkins; Volume: 192; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2014.05.091

1527-3792

Alejandra Mira Moreno, María Dolores Montoya Lirola, Pedro José García Tabar, Juan Francisco Galiano Baena, José Antonio Tenza Tenza, J.J. Lobato Encinas,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyAdult Urology1 Nov 2014Incidence of Infectious Complications after Extracorporeal Shock Wave Lithotripsy in Patients Without Associated Risk Factors Alejandra Mira Moreno, María Dolores Montoya Lirola, Pedro José García Tabar, Juan Francisco Galiano Baena, José Antonio Tenza Tenza, and Juan José Lobato Encinas Alejandra Mira MorenoAlejandra Mira Moreno More articles by this author , María Dolores Montoya LirolaMaría Dolores Montoya Lirola More articles by this author , Pedro José García TabarPedro José García Tabar More articles by this author , Juan Francisco Galiano BaenaJuan Francisco Galiano Baena More articles by this author , José Antonio Tenza TenzaJosé Antonio Tenza Tenza More articles by this author , and Juan José Lobato EncinasJuan José Lobato Encinas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.05.091AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the incidence of infectious complications (asymptomatic bacteriuria, urinary tract infection and urosepsis) in patients without associated risk factors treated with extracorporeal shock wave lithotripsy. Materials and Methods: We performed an observational, prospective cohort study between October 2010 and June 2013. We included all patients without risk factors who were treated with extracorporeal shock wave lithotripsy for kidney or ureteral lithiasis. All patients underwent urine culture 5 days before the procedure. Another urine culture was performed 7 days after lithotripsy. No patient received antibiotics. Results: Initially 366 patients with a mean ± SD age of 53 ± 13 years were enrolled in the study. A total of 64 patients (17.5%) underwent extracorporeal shock wave lithotripsy with a previously placed Double-J® stent. After lithotripsy urine culture was positive in 20 patients (5.8%), of whom 4 (1.2%) presented with symptomatic urinary infection and the remaining 4.6% showed no symptoms. Urosepsis did not develop in any case. In our study patient age was an independent risk factor for bacteriuria after lithotripsy. Conclusions: The incidence of infectious complications after extracorporeal shock wave lithotripsy in patients without risk factors is low. This leads us to conclude that without defined risk factors antibiotic prophylaxis is not justified. Also, elderly patients were more at risk for bacteriuria after extracorporeal shock wave lithotripsy and, thus, for a possible infectious complication. References 1 : Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol2006; 50: 981. Google Scholar 2 : Is urinary tract infection after shock wave lithotripsy an aggravating factor for renal damage?. Arch Esp Urol2010; 63: 454. Google Scholar 3 : Bacteriuria following extracorporeal shock-wave lithotripsy in patients whose urine was sterile before the procedure. Clin Infect Dis1995; 20: 1317. Google Scholar 4 : The incidence of urinary tract infection in patients without bacteriuria who underwent extracorporeal shock wave lithotripsy. J Urol1994; 151: 329. Abstract, Google Scholar 5 : Incidence of urinary tract infection in patients without bacteriuria undergoing ESWL: comparison of stone types. J Endourol1998; 12: 1. Google Scholar 6 : Extracorporeal shock wave lithotripsy of kidney stones does not induce transient bacteraemia. A prospective study. J Urol1990; 144: 15. Abstract, Google Scholar 7 : The value of antibiotic prophylaxis during extracorporeal shock wave lithotripsy in the prevention of urinary tract infections in patients with urine proven sterile prior to treatment. Eur Urol1997; 31: 30. Google Scholar 8 : Antimicrobial prophylaxis prior to shock wave lithotripsy in patients with sterile urine before treatment: a meta-analysis and cost-effectiveness analysis. Urology1997; 49: 679. Google Scholar 9 : Antimicrobial prophylaxis in management of urinary tract stones by extracorporeal shock-wave lithotripsy: is it necessary?. Urology1995; 46: 165. Google Scholar 10 : Antibiotic prophylaxis for shock wave lithotripsy in patients with sterile urine before treatment may be unnecessary: a systematic review and meta-analysis. J Urol2012; 188: 441. Link, Google Scholar 11 : A prospective study examining the incidente of bacteriuria and urinary tract infection post-shockwave lithotripsy with targeted antibiotic prophylaxis. J Urol2013; 189: 112. Google Scholar 12 : A prospective study examining the incidence of bacteriuria and urinary tract infection post-shockwave lithotripsy: the case against universal antibiotic prophylaxis. J Urol2011; 185: e472. Link, Google Scholar 13 : Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol2008; 179: 1379. Link, Google Scholar 14 : Guidelines on Urolithiasis. Arnhem, The Netherlands: European Association of Urology2013: 25. Google Scholar 15 : Antibioterapia profiláctica en la litotricia extracorpórea por ondas de choque (LEOC): estudio prospectivo y randomizado. Actas Urol Esp1991; 15: 442. Google Scholar 16 : Epidemiology of urinary tract infections: incident, morbidity, and economic costs. Am J Med2002; 113: 5S. Google Scholar 17 : The necessity of prophylactic antibiotics during extracorporeal shock wave lithotripsy. Int Urol Nephrol1997; 29: 517. Google Scholar 18 : Necessity of antibiotics prophylaxis during extracorporeal shock wave lithotripsy. Mymensingh Med J2005; 14: 58. Google Scholar 19 : Extracorporeal shock wave lithotripsy. Use of antibiotics to avoid postprocedural infection. Postgrad Med1988; 89: 199. Google Scholar 20 : Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol2008; 54: 1270. Google Scholar 21 : Fever after shockwave lithotripsy-risk factors and indications form prophylactic antimicrobial treatment. J Endourol2010; 24: 277. Google Scholar 22 : Complicating risk factors for pyelonephritis alter extracorporeal shock wave lithotripsy. Int J Urol2000; 7: 224. Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 192Issue 5November 2014Page: 1446-1449 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordskidneyurolithiasisureterantibiotic prophylaxislithotripsyMetricsAuthor Information Alejandra Mira Moreno More articles by this author María Dolores Montoya Lirola More articles by this author Pedro José García Tabar More articles by this author Juan Francisco Galiano Baena More articles by this author José Antonio Tenza Tenza More articles by this author Juan José Lobato Encinas More articles by this author Expand All Advertisement PDF downloadLoading ...