Necessity of antibacterial prophylaxis in the treatment of reno-ureteral lithiasis by extracorporeal shock wave lithotripsy. A prospective descriptive study

Abstract

ABSTRACT.

Introduction. Due to the increase in the incidence of reno-ureteral lithiasis worldwide from 1% to 15%, varying according to age, sex, race, and geographical location, extracorporeal shock wave lithotripsy remains the method of choice in the treatment of reno-ureteral lithiasis. The need for antibacterial prophylaxis is required only in well-defined cases, uroculture with antibacterial sensitivity being crucial in order to reduce the infectious complications.

The objective of the study was to evaluate the need for antibiotic administration and to detect risk factors for the development of post-ESWL bacteriuria.

Material and methods. Between 05 Nov 2018 – 10 Dec 2019, a group of 120 patients with the diagnosis of reno-ureteral lithiasis was selected, who underwent ESWL treatment in Department of Urology and Surgical Nephrology from Republican Clinical Hospital „Timofei Mosneaga“. In all 120 patients, urine sample was taken before and after ESWL. In all patients included in the study, uroculture with antibiogram was performed.

Results. The uroculture results obtained before ESWL were positive in 25 (20.84%) patients without any clinical symptoms and absence of leukocytes in the general urine analysis more than 10 per high power field. At the same time, the number of positive urine culture after ESWL increased significantly in 47 patients.

Conclusions. Antibiotic prophylaxis is not justified in the absence of definite risk factors such as positive urine culture before ESWL, JJ stent or nephrostome and a history of infectious reno-ureteral lithiasis or recurrent urinary tract infections.