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Purpose <p>Endoscopic lithotripsy has become widely adopted worldwide and is considered the gold standard for managing upper urinary tract lithiasis. One of its possible complications is post-operative infection. We aimed to review available literature about the role of preoperative antibiotic prophylaxis and its indications.</p> Methods <p>We performed a systematic search of the literature including “ureteroscopy”, “PNL”, “retrograde intrarenal surgery”, “antibiotic prophylaxis” and “sepsis” as keywords. Out of 760 relevant studies only 13 met our inclusion criteria: at least 10 adult patients (≥ 18 years old) diagnosed with kidney or ureteral stones; antibiotic prophylaxis described and reported; post-operative sepsis, UTI or SIRS assessed.</p> Conclusions <p>Antibiotic prophylaxis strategies for stone surgery show different degrees of effectiveness depending on both the approach and the patient’s condition. Today’s evidence suggests that while routine antibiotic prophylaxis might not be necessary for all patients with sterile urine undergoing ureterorenoscopy and lithotripsy vs. percutaneous nephrolithotripsy, for those patients with positive preoperative urine cultures it is beneficial reducing the risk of postoperative infective complications.</p>

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Antibiotic prophylaxis in stone surgery: a systematic review of the literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月3日

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  • Filippo Gavi,
  • Mauro Ragonese,
  • Daniele Fettucciari,
  • Maria Chiara Sighinolfi,
  • Filippo Turri,
  • Enrico Panio,
  • Stefano Moretto,
  • Giovanni Balocchi,
  • Domenico Maria Sanesi,
  • Filippo Marino,
  • Alessandra Francocci,
  • Pierluigi Russo,
  • Nazario Foschi,
  • Francesco Pinto,
  • Emilio Sacco,
  • Bernardo Rocco

摘要

Purpose

Endoscopic lithotripsy has become widely adopted worldwide and is considered the gold standard for managing upper urinary tract lithiasis. One of its possible complications is post-operative infection. We aimed to review available literature about the role of preoperative antibiotic prophylaxis and its indications.

Methods

We performed a systematic search of the literature including “ureteroscopy”, “PNL”, “retrograde intrarenal surgery”, “antibiotic prophylaxis” and “sepsis” as keywords. Out of 760 relevant studies only 13 met our inclusion criteria: at least 10 adult patients (≥ 18 years old) diagnosed with kidney or ureteral stones; antibiotic prophylaxis described and reported; post-operative sepsis, UTI or SIRS assessed.

Conclusions

Antibiotic prophylaxis strategies for stone surgery show different degrees of effectiveness depending on both the approach and the patient’s condition. Today’s evidence suggests that while routine antibiotic prophylaxis might not be necessary for all patients with sterile urine undergoing ureterorenoscopy and lithotripsy vs. percutaneous nephrolithotripsy, for those patients with positive preoperative urine cultures it is beneficial reducing the risk of postoperative infective complications.