Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial
Introduction: Endourological surgeries like Percutaneous Nephrolithotripsy (PCNL) and Ureteroscopic Lithotripsy (URSL) is the standard of care for upper urinary tract urolithiasis. Placement of Double J stent (DJ stent) is a routine practice, following these surgical interventions. Though endour...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2022-10-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/16896/51499_CE[SH]_F[SH]_PF1(RV_Ab_SS)_PFA(SS)_PN(SS).pdf |
| _version_ | 1797895492875583488 |
|---|---|
| author | Pramod Jagadeesh Makannavar Srinivas Kalabavi Revanasiddappa Kanagali Sangamnath Bentur |
| author_facet | Pramod Jagadeesh Makannavar Srinivas Kalabavi Revanasiddappa Kanagali Sangamnath Bentur |
| author_sort | Pramod Jagadeesh Makannavar |
| collection | DOAJ |
| description | Introduction: Endourological surgeries like Percutaneous
Nephrolithotripsy (PCNL) and Ureteroscopic Lithotripsy (URSL) is
the standard of care for upper urinary tract urolithiasis. Placement
of Double J stent (DJ stent) is a routine practice, following these
surgical interventions. Though endourological surgeries are less
invasive, these are not without complications. Main postoperative
complications following these procedures, which hamper daily
activities are Urinary Tract Infection (UTI) and Stent Related
Symptoms (SRS). There is a lack of literature, about appropriate
postoperative antibiotic strategy following uncomplicated
endourological surgery for upper urinary tract stone disease in
patients, who are on DJ stent.
Aim: To evaluate the incidence of UTI and SRS in patients given, a
peri-interventional antibiotic prophylaxis only versus a continuous
low-dose antibiotic treatment for entire stent indwelling time.
Materials and Methods: This was a randomised clinical study
conducted in the Department of Urology, SDM Medical College
and Hospital, Dharwad, Karnataka, India from january 2020-
march 2021. A total of 70 patients following uncomplicated
endourological surgery were randomised, to either receive periinterventional antibiotic prophylaxis only (group A=31) or low-dose antibiotic treatment for entire stent indwelling time (group B=39).
Randomisation was done to allocate sample into two groups
using computer randomisation program. All patients received
cefotaxime injection 1 gm at the time of anaesthesia induction
as peri intervention prophylaxis. Patients in group B, in addition
received nitrofurantoine 100 mg tablet at bedtime for entire stent
indwelling time. Patients were evaluated for incidence of UTI
and SRSs. Statistical analysis was done using Chi-square and
Yates corrected Chi-square for analysis of association between
attributes. Independent t-test was used for comparison of two
groups with numerical variables.
Results: The incidence of UTI was not significantly different
between the two groups {group A- 4 (12.9%) and group B- 6
(15.38%)}. UTI was more common following URSL compared to
PCNL {group A 24 (77.42%) and group B 29 (74.36%)}, and more
common in those with diabetes mellitus. Similarly the incidence
and severity of SRSs was very similar in both the groups {group
A 28 (90.32%) and group B 37 (94.87%)}.
Conclusion: According to the present study findings, continuous
low-dose antibiotic treatment during entire stent indwelling time
does not reduce the incidence of UTI and has no effect on
SRSs. |
| first_indexed | 2024-04-10T07:26:34Z |
| format | Article |
| id | doaj.art-93b2fb57cfa543549f2f4f6714d5da3d |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T07:26:34Z |
| publishDate | 2022-10-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-93b2fb57cfa543549f2f4f6714d5da3d2023-02-24T05:47:58ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-10-011610PC01PC0410.7860/JCDR/2022/51499.16896Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical TrialPramod Jagadeesh Makannavar0Srinivas Kalabavi1Revanasiddappa Kanagali2Sangamnath Bentur3Assistant Professor, Department of Urology, SDM Medical College and Hospital, Dharwad, Karnataka, India.Professor, Department of Urology, SDM Medical College and Hospital, Dharwad, Karnataka, India.Assistant Professor, Department of Urology, SDM Medical College and Hospital, Dharwad, Karnataka, India.Assistant Professor, Department of Urology, SDM Medical College and Hospital, Dharwad, Karnataka, India.Introduction: Endourological surgeries like Percutaneous Nephrolithotripsy (PCNL) and Ureteroscopic Lithotripsy (URSL) is the standard of care for upper urinary tract urolithiasis. Placement of Double J stent (DJ stent) is a routine practice, following these surgical interventions. Though endourological surgeries are less invasive, these are not without complications. Main postoperative complications following these procedures, which hamper daily activities are Urinary Tract Infection (UTI) and Stent Related Symptoms (SRS). There is a lack of literature, about appropriate postoperative antibiotic strategy following uncomplicated endourological surgery for upper urinary tract stone disease in patients, who are on DJ stent. Aim: To evaluate the incidence of UTI and SRS in patients given, a peri-interventional antibiotic prophylaxis only versus a continuous low-dose antibiotic treatment for entire stent indwelling time. Materials and Methods: This was a randomised clinical study conducted in the Department of Urology, SDM Medical College and Hospital, Dharwad, Karnataka, India from january 2020- march 2021. A total of 70 patients following uncomplicated endourological surgery were randomised, to either receive periinterventional antibiotic prophylaxis only (group A=31) or low-dose antibiotic treatment for entire stent indwelling time (group B=39). Randomisation was done to allocate sample into two groups using computer randomisation program. All patients received cefotaxime injection 1 gm at the time of anaesthesia induction as peri intervention prophylaxis. Patients in group B, in addition received nitrofurantoine 100 mg tablet at bedtime for entire stent indwelling time. Patients were evaluated for incidence of UTI and SRSs. Statistical analysis was done using Chi-square and Yates corrected Chi-square for analysis of association between attributes. Independent t-test was used for comparison of two groups with numerical variables. Results: The incidence of UTI was not significantly different between the two groups {group A- 4 (12.9%) and group B- 6 (15.38%)}. UTI was more common following URSL compared to PCNL {group A 24 (77.42%) and group B 29 (74.36%)}, and more common in those with diabetes mellitus. Similarly the incidence and severity of SRSs was very similar in both the groups {group A 28 (90.32%) and group B 37 (94.87%)}. Conclusion: According to the present study findings, continuous low-dose antibiotic treatment during entire stent indwelling time does not reduce the incidence of UTI and has no effect on SRSs.https://jcdr.net/articles/PDF/16896/51499_CE[SH]_F[SH]_PF1(RV_Ab_SS)_PFA(SS)_PN(SS).pdfantimicrobial prophylaxisendourological surgerypercutaneous nephrolithotripsyurinary tract infection |
| spellingShingle | Pramod Jagadeesh Makannavar Srinivas Kalabavi Revanasiddappa Kanagali Sangamnath Bentur Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial Journal of Clinical and Diagnostic Research antimicrobial prophylaxis endourological surgery percutaneous nephrolithotripsy urinary tract infection |
| title | Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial |
| title_full | Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial |
| title_fullStr | Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial |
| title_full_unstemmed | Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial |
| title_short | Incidence of UTI and Stent-related Symptoms in Patients with Peri-interventional Antibiotic Prophylaxis Only vs Low-dose Continuous Antibiotic Treatment among Double J Stented Patients: A Randomised Clinical Trial |
| title_sort | incidence of uti and stent related symptoms in patients with peri interventional antibiotic prophylaxis only vs low dose continuous antibiotic treatment among double j stented patients a randomised clinical trial |
| topic | antimicrobial prophylaxis endourological surgery percutaneous nephrolithotripsy urinary tract infection |
| url | https://jcdr.net/articles/PDF/16896/51499_CE[SH]_F[SH]_PF1(RV_Ab_SS)_PFA(SS)_PN(SS).pdf |
| work_keys_str_mv | AT pramodjagadeeshmakannavar incidenceofutiandstentrelatedsymptomsinpatientswithperiinterventionalantibioticprophylaxisonlyvslowdosecontinuousantibiotictreatmentamongdoublejstentedpatientsarandomisedclinicaltrial AT srinivaskalabavi incidenceofutiandstentrelatedsymptomsinpatientswithperiinterventionalantibioticprophylaxisonlyvslowdosecontinuousantibiotictreatmentamongdoublejstentedpatientsarandomisedclinicaltrial AT revanasiddappakanagali incidenceofutiandstentrelatedsymptomsinpatientswithperiinterventionalantibioticprophylaxisonlyvslowdosecontinuousantibiotictreatmentamongdoublejstentedpatientsarandomisedclinicaltrial AT sangamnathbentur incidenceofutiandstentrelatedsymptomsinpatientswithperiinterventionalantibioticprophylaxisonlyvslowdosecontinuousantibiotictreatmentamongdoublejstentedpatientsarandomisedclinicaltrial |