Enhanced versus extended preoperative antibiotic prophylaxis for retrograde intrarenal surgery in high infectious risk patients: a randomized controlled trial
Abstract
OBJECTIVES: To compare enhanced (2 days) antibiotic prophylaxis (AP) versus extended (7 days) AP in terms of rate and grade of infectious complications post RIRS in high-risk patients. In addition, we aimed to identify the risk factors related to these devastating complications. PATIENTS AND METHODS: After institutional review board (IRB) approval, 145 patients were randomized into two groups; enhanced and extended groups. Baseline clinical, laboratory and radiological characteristics were compared between the two groups. Primary outcome was incidence of post-RIRS infectious complications. Secondary outcomes comprised length of hospital stay, stone free rate (SFR), unplanned visits and hospital readmissions. Univariate and multivariate logistic regression analyses were utilized to identify independent predictors of post-RIRS infectious complications. RESULTS: The two study groups were comparable for preoperative baseline patients’ and stone characteristics. Asymptomatic bacteriuria, diabetes mellitus and lengthy dwelling ureteral stents were identified in 66 (45.5%), 51 (35%) and 113 (78%) patients, respectively. The rate of post-RIRS infectious complications was comparable between the two groups (36% in enhanced group and 24% in extended group, P = 0.81). There were no differences between the two groups in terms of grade of infectious complications or infected postoperative urine culture (P = 0.74, and 0.06, respectively). Length of stay, SFR and unplanned visits and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 145 participants or records.
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