ANTIMICROBIAL PROPHYLAXIS IN MANAGEMENT OF URINARY-TRACT STONES BY EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY - IS IT NECESSARY

Objectives. In a prospective randomized study, we evaluated the incide nce of urinary tract infections following extracorporeal shock-wave li thotripsy (ESWL) and the necessity of prophylactic antibiotic administ ration in patients treated with this modality. Methods. A total of 360 consecutive patients with renal and ureteric stones who had sterile u rine before ESWL treatment and did not have any increased risk of infe ction received either a single dose of 400 mg of ofloxacin or no proph ylaxis. Patients were followed by simple urine analysis and urine cult ures together, with clinical evaluations. Results. Only 3 patients (0. 8%) had positive urine cultures at 1 week after ESWL. Two of these pat ients were in the antibiotic prophylaxis group. Conclusions. The incid ence of urinary tract infections after ESWL is extremely low, provided that patients have sterile urine before ESWL, and prophylactic antibi otics are not required.