Empirical antibiotic prophylaxis versus culture-directed enhanced prophylaxis for prevention of urinary tract infection after flexible ureteroscopy in children: A randomized controlled trial
Abstract
OBJECTIVE
This study aims to compare the effects of empirical antibiotic prophylaxis versus culture-directed enhanced prophylactic measures on the rate of urinary tract infection (UTI) after flexible ureteroscopy (FURS) in children.
METHODS
A randomized controlled study was conducted at our tertiary center between July 1, 2024, and December 1, 2024, involving 140 patients with renal or ureteric stones. Patients were randomly allocated to receive either empirical antibiotic or culture-directed enhanced prophylaxis (preoperative urine culture followed by culture-directed antibiotic therapy when indicated). Stone burden was determined using non-contrast computed tomography of the urinary tract (NCCT). The primary outcome was the incidence of postoperative symptomatic UTI within 30 days, defined as the presence of fever (38 °C) and suspected sepsis without organ failure requiring supportive therapy and enhanced monitoring in addition to the antibiotic therapy.
INCLUSION CRITERIA
age 4-16 years, renal/ureteric stones 1-1.5 cm.
EXCLUSION CRITERIA
congenital renal anomalies, single functioning kidney, active symptomatic UTI at time of randomization, neuropathic bladder, diabetes, coagulopathy, elevated creatinine, or cardiorespiratory comorbidity.
RESULTS
Patient and stone characteristics were similar in both groups. There was no statistically significant difference between groups according to hospitalization time, readmission rates, or intraoperative complications. The overall…
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.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.