Single-dose fosfomycin could prevent infectious complications after retrograde intrarenal surgery: A prospective study La fosfomycine à dose unique pourrait prévenir les complications infectieuses après une chirurgie intrarénale rétrograde: une étude prospective


GÖKALP F., Abat D., Koras O., Yildirak E., Sigva H., Kulak B., ...Daha Fazla

Progres en Urologie, cilt.33, sa.3, ss.110-117, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 33 Sayı: 3
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1016/j.purol.2022.12.011
  • Dergi Adı: Progres en Urologie
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, Gender Studies Database, MEDLINE
  • Sayfa Sayıları: ss.110-117
  • Anahtar Kelimeler: Antibiotherapy, Fosfomycin, Infectious complications, Prophylaxis, Retrograde intrarenal surgery, Urolithiasis
  • Hatay Mustafa Kemal Üniversitesi Adresli: Evet

Özet

Background: In this study, we aimed to show the protective effect of a single-dose Fosfomycin from infective complications against the standard usage of cephalosporine before retrograde intrarenal surgery. Material: A total of 186 patients who underwent retrograde intrarenal surgery between 2020 and 2021, included the study. Patients were divided into two groups: group 1(n = 49), patients who received an oral dose of 3 g Fosfomycin tromethamine powder administered 4–6 h before the operation; and group 2 (n = 137): patients who received Cephalosporin 30 min before surgery and an additional dose 6 h after surgery. Results: The median age and stone size were significantly higher in the cephalosporin group (P = 0.006 and P = 0.008, respectively). There was no statistically significant difference between the groups in terms of postoperative fever and postoperative UTI (P = 0.408 and P = 0.438). Additionally, no patient developed sepsis. and no adverse event was seen in either group. Preoperative urinary tract infection (UTI) and previous Extracorporeal Shock Wave lithotripsy (ESWL) were independent risk factors and increased postoperative infectious complications (O.R. 2.929 95% C.I. 0.723, P < 0.001, and O.R. 2.860 95% C.I. 0.985, P = 0.004, respectively). Conclusion: Infectious is still one of the important complications after RIRS, and preoperative UTI is an independent risk factors for infections. Fosfomycin monotherapy could be sufficient and is also effective in patients with preoperative culture positive.