a prospective study examining the incidence of bacteriuria and urinary tract infection after shock wave lithotripsy with targeted antibiotic prophylaxis：一项前瞻性研究对菌尿和尿路感染的发生率有针对性的抗生素预防冲击波碎石术后.pdfVIP

Infection/Inflammation A Prospective Study Examining the Incidence of Bacteriuria and Urinary Tract Infection After Shock Wave Lithotripsy with Targeted Antibiotic Prophylaxis R. John D’A. Honey,*,† Michael Ordon,‡ Daniela Ghiculete,‡ Joshua D. Wiesenthal,§ Ronald Kodama‡ and Kenneth T. Pace From the Division of Urology, St. Michael’s Hospital (RJDH, MO, DG, JDW, KTP) and Sunnybrook Health Science Centre (RK), University of Toronto, Toronto, Ontario, Canada Abbreviations Purpose: Controversy exists regarding antibiotic prophylaxis before shock wave and Acronyms lithotripsy. The AUA (American Urological Association) guideline recommends ASB asymptomatic bacteriuria universal antibiotic prophylaxis, whereas the EAU (European Association of Urology) guideline recommends prophylaxis only for select patients. We evalu- NPV negative predictive value ated the use of targeted antibiotic prophylaxis in preventing urinary tract infec- PPV positive predictive value tions in patients undergoing shock wave lithotripsy. RCT randomized controlled trial Materials and Methods: A prospective single cohort study was performed during SWL shock wave lithotripsy 6 months with patients undergoing shock wave lithotripsy. All patients under- UTI urinary tract infection went urine dipstick and culture before shock wave lithotripsy. Targeted antibiotic prophylaxis was provided at the discretion of the treating urologist. All patients Accepted for publication December 19, 2012. had a urine culture performed after shock wave lithotripsy and completed a Study received Research Ethics Board ap- survey documenting fevers or urinary symptoms. The primary outcome