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Perioperative antibiotic prophylaxis for stone therapy

Schnabel, Marco J.a; Wagenlehner, Florian M.E.b; Schneidewind, Lailac

doi: 10.1097/MOU.0000000000000576

Purpose of review To give an overview about state-of-the-art antibiotic prophylaxis in urolithasis therapy and focus on recent publications in this field.

Recent findings The number of high-quality publications within the recent time is limited. Preoperative inflammatory blood parameters like C-reactive protein and erythrocyte-sedimentation rate might help in prediction of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). White blood cell count is nonpredictive for urinary tract infection (UTI) in patients with acute renal colic. In patients with low risk for infectious complications, antibiotic prophylaxis during shock-wave lithotripsy (SWL) is unnecessary and single-dose antibiotics are comparably effective as prolonged antibiotic usage during PCNL and ureterorenoscopy (URS).

Summary Current findings support the American Urological Association (AUA) and European Association of Urology (EAU) guideline recommendations for a risk-adapted minimal antibiotic usage. Single-dose antibiotic prophylaxis is sufficient for low-risk PCNL and URS. For SWL no antibiotic prophylaxis is needed.

aDepartment of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg

bDepartment of Urology, Paediatric Urology and Andrology, University Hospital Giessen, Giessen

cDepartment of Haematology/Oncology, University Medicine Greifswald, Greifswald, Germany

Correspondence to Marco J. Schnabel, MD, Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Landshuter Str. 65, 93053 Regensburg, Germany. Tel: +49 941 782 3510; e-mail:

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