NEW ORLEANS, LA USA (UroToday.com) - An online survey was distributed by e-mail to members of the Endourological Society. The survey queried the duration of antimicrobial therapy prior to uncomplicated ureteroscopy (URS) and percutaneous nephrolithotomy (PNL) with negative and asymptomatic positive pre-operative urine cultures. 369 responded to the survey and almost 2/3 of them were endourology fellowship trained. The majority of respondents reported giving a single perioperative dose in patients with a negative urine culture; however almost 1/3 still utilize antibiotics for longer time in patients with a negative urine culture prior to URS and PNL; respectively.
In patients with positive cultures, there were even more heterogeneous responses. The survey results showed significant variations in antimicrobial utilization prior to endourological management by geographical location of practice. It was noticed that the guidelines are not followed strictly worldwide. In Europe, < 20% followed European guidelines and recommended not giving antibiotics before URS for distal ureteric stone and no infection. Prior to URS for a renal stone in patients with negative urine culture, 20% of urologists who responded in the USA and Europe recommended utilization of antibiotics for > 1 day.
The interesting survey results urge for well-designed, prospective, randomized studies to guide appropriate utilization of antibiotics before stone surgeries.
Presented by Adam Kaplan, MD at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Duke University Hospital, Durham, NC USA
Reported by Ramy Youssef, MD (University of California-Irvine), medical writer for UroToday.com