Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis

Purpose: There is no consensus on the optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy in patients presenting with urolithiasis-induced obstructive acute pyelonephritis (APN). We aimed to identify surgeon-modifiable, preoperative risk factors associated with p...

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Autores principales:	Jeong Woo Yoo, Kwang Suk Lee, Byung Ha Chung, Se Yun Kwon, Young Jin Seo, Kyung Seop Lee, Kyo Chul Koo
Formato:	article
Lenguaje:	EN
Publicado:	Korean Urological Association 2021
Materias:	antibiotics systemic inflammatory response syndrome urinary tract infections urolithiasis Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/fae8a258978e4ae2a60591a388cc5ffd
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spelling	oai:doaj.org-article:fae8a258978e4ae2a60591a388cc5ffd2021-11-10T05:01:40ZOptimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis10.4111/icu.202101602466-04932466-054Xhttps://doaj.org/article/fae8a258978e4ae2a60591a388cc5ffd2021-11-01T00:00:00Zhttps://icurology.org/pdf/10.4111/icu.20210160https://doaj.org/toc/2466-0493https://doaj.org/toc/2466-054XPurpose: There is no consensus on the optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy in patients presenting with urolithiasis-induced obstructive acute pyelonephritis (APN). We aimed to identify surgeon-modifiable, preoperative risk factors associated with postoperative systemic inflammatory response syndrome (SIRS) in these patients. Materials and Methods: This multicenter retrospective study evaluated 115 patients who presented with urolithiasis-induced obstructive APN between January 2008 and December 2019. All patients were administered intravenous third-generation cephalosporin until culture sensitivity confirmation or until ureteroscopic lithotripsy. Data were collected for age, sex, diabetes mellitus, performance status, stone features, hydronephrosis grade, preoperative renal collecting system drainage, laboratory data, operative time, and duration of preoperative antibiotic treatment. Sensitivity analysis using Youden's index and logistic regression analysis were used to assess risk factors of postoperative SIRS. Results: Postoperative SIRS was identified in 32 (27.8%) patients. The incidence of postoperative SIRS was higher in patients who received preoperative antibiotic treatment for fewer than 14 days (38.8% vs. 12.5%; p=0.001). Backward variable selection logistic regression analysis revealed maximal stone diameter ≥15 mm, duration of preoperative antibiotic treatment <14 days, and preoperative C-reactive protein (CRP) level ≥6.0 mg/L to be associated with higher risk of postoperative SIRS. Conclusions: Patients with urolithiasis-induced obstructive APN planned for ureteroscopic lithotripsy should be administered at least 14 days of preoperative antibiotic administration and achieve a serum CRP level ≤6.0 mg/L to minimize the risk of postoperative SIRS.Jeong Woo YooKwang Suk LeeByung Ha ChungSe Yun KwonYoung Jin Seo Kyung Seop LeeKyo Chul Koo Korean Urological Associationarticleantibioticssystemic inflammatory response syndromeurinary tract infectionsurolithiasisDiseases of the genitourinary system. UrologyRC870-923ENInvestigative and Clinical Urology, Vol 62, Iss 6, Pp 681-689 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antibiotics systemic inflammatory response syndrome urinary tract infections urolithiasis Diseases of the genitourinary system. Urology RC870-923
spellingShingle	antibiotics systemic inflammatory response syndrome urinary tract infections urolithiasis Diseases of the genitourinary system. Urology RC870-923 Jeong Woo Yoo Kwang Suk Lee Byung Ha Chung Se Yun Kwon Young Jin Seo Kyung Seop Lee Kyo Chul Koo Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
description	Purpose: There is no consensus on the optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy in patients presenting with urolithiasis-induced obstructive acute pyelonephritis (APN). We aimed to identify surgeon-modifiable, preoperative risk factors associated with postoperative systemic inflammatory response syndrome (SIRS) in these patients. Materials and Methods: This multicenter retrospective study evaluated 115 patients who presented with urolithiasis-induced obstructive APN between January 2008 and December 2019. All patients were administered intravenous third-generation cephalosporin until culture sensitivity confirmation or until ureteroscopic lithotripsy. Data were collected for age, sex, diabetes mellitus, performance status, stone features, hydronephrosis grade, preoperative renal collecting system drainage, laboratory data, operative time, and duration of preoperative antibiotic treatment. Sensitivity analysis using Youden's index and logistic regression analysis were used to assess risk factors of postoperative SIRS. Results: Postoperative SIRS was identified in 32 (27.8%) patients. The incidence of postoperative SIRS was higher in patients who received preoperative antibiotic treatment for fewer than 14 days (38.8% vs. 12.5%; p=0.001). Backward variable selection logistic regression analysis revealed maximal stone diameter ≥15 mm, duration of preoperative antibiotic treatment <14 days, and preoperative C-reactive protein (CRP) level ≥6.0 mg/L to be associated with higher risk of postoperative SIRS. Conclusions: Patients with urolithiasis-induced obstructive APN planned for ureteroscopic lithotripsy should be administered at least 14 days of preoperative antibiotic administration and achieve a serum CRP level ≤6.0 mg/L to minimize the risk of postoperative SIRS.
format	article
author	Jeong Woo Yoo Kwang Suk Lee Byung Ha Chung Se Yun Kwon Young Jin Seo Kyung Seop Lee Kyo Chul Koo
author_facet	Jeong Woo Yoo Kwang Suk Lee Byung Ha Chung Se Yun Kwon Young Jin Seo Kyung Seop Lee Kyo Chul Koo
author_sort	Jeong Woo Yoo
title	Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
title_short	Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
title_full	Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
title_fullStr	Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
title_full_unstemmed	Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
title_sort	optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis
publisher	Korean Urological Association
publishDate	2021
url	https://doaj.org/article/fae8a258978e4ae2a60591a388cc5ffd
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Optimal duration of preoperative antibiotic treatment prior to ureteroscopic lithotripsy to prevent postoperative systemic inflammatory response syndrome in patients presenting with urolithiasis-induced obstructive acute pyelonephritis

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