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Comparing the effect of peri-operative antibiotic prophylaxis only with continuous low-dose antibiotic treatment on the incidence of urinary tract infection and stent related-symptoms in patients undergoing Double-J (DJ) stent insertion following transurethral lithotripsy (TUL)

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Abstract

Purpose

There are some controversial data about the peri operative use of antibiotics after double-J (DJ) insertion. This study aimed to compare the rates of urinary tract infections (UTI) and stent-related symptoms (SRSs) in patients who received only perioperative antibiotic prophylaxis and those given continuous low-dose antibiotic therapy for the entire stent-indwelling time following transurethral lithotripsy (TUL).

Methods

In this randomized clinical trial 178 patients received intravenous antibiotic prophylaxis (ciprofloxacin 400 mg) before the TUL and then randomly divided into two groups to either receive no antibiotic treatment after procedure (group A, 90 patients) or to additionally receive a continuous low-dose antibiotic treatment with one ciprofloxacin 500 mg every 12 h for 3 days and then ciprofloxacin 250 mg once daily for the entire stent-indwelling time (group B, 88 patients). The rates of UTIs, SRSs and incidence of drug side-effects were evaluated in groups.

Results

A total of 7 patients had positive urine culture [group A: 4 (4.4%) vs. group B: 3 (3.4%); P = 0.722]. Only 1 patient in group B had febrile UTI in the mean duration of indwelling stent in situ. The rate of SRSs was 92.2% and 89.8% in Group A and B, respectively, with no significant difference (P = 0.609). A total of 4 patients in Group B complained of gastrointestinal side effects of ciprofloxacin.

Conclusion

Continuous low-dose antibiotic treatment has no role in reducing the incidence of UTIs and SRSs during the indwelling time of ureteral stents compared with the peri-operative antibiotic prophylaxis only.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This study was supported by Urology Research Center, Guilan University of Medical Sciences.

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Authors and Affiliations

  1. Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Reza Shahrokhi Damavand, Samaneh Esmaeili, Bahador Heidari Bateni, Ardalan Akhavan Tavakoli & Ehsan Kazemnezhad

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  1. Reza Shahrokhi Damavand
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  2. Samaneh Esmaeili
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  3. Bahador Heidari Bateni
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Contributions

RSD: Project development, Manuscript editing. SE: Data management, Data analysis, Manuscript writing. BHB: Data collection, Manuscript writing, Manuscript editing. AAT: Data collection, Manuscript editing. EK: Data analysis.

Corresponding author

Correspondence to Bahador Heidari Bateni.

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Authors declare that have no conflict of interest for this manuscript and do not have any financial interest.

Research involving human participants and/or animals

Research involving personal data of human participants, and the researchers performed it in compliance with all legal and ethical requirements.

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The study was retrospective and all personal information of the patients remained confidential. Also, the principles of trusteeship were fully respected by the researchers.

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Damavand, R.S., Esmaeili, S., Bateni, B.H. et al. Comparing the effect of peri-operative antibiotic prophylaxis only with continuous low-dose antibiotic treatment on the incidence of urinary tract infection and stent related-symptoms in patients undergoing Double-J (DJ) stent insertion following transurethral lithotripsy (TUL). World J Urol 41, 3027–3032 (2023). https://doi.org/10.1007/s00345-023-04585-8

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