Complicating risk factors for pyelonephritis after extracorporeal shock wave lithotripsy

Purpose: The score to predict the risk of post-extracorporeal shock wave li thotripsy (ESWL) pyelonephritis was evaluated. The score was based on the m ultivariate analysis of risk factors available pre-operatively. Stone size, pyuria, bacteriuria, previous pyelonephritis and other adjunctive procedur es had been selected and scored. Methods: Three-hundred and forty-eight adult patients without active urinar y infection undergoing ESWL therapy were studied. One of three regimens wer e selected by either doctor or patient: (i) no antimicrobial treatment; (ii ) one dose of levofloxacin; or (iii) 1 week course of levofloxacin. Who and why selected it were described. Post-ESWL fever over 38 degrees C was defi ned as the unfavorable event. Results/conclusion: With increasing score, doctors recommend taking an anti microbial. There were 11 bacteriuric patients and post-ESWL pyelonephritis developed in one of them. Bacteria within the stone and post-ESWL ureteral obstruction caused by the stone fragments were considered to be important i n developing pyelonephritis. However, multiple factors were related with it . Although their decision was not based simply on the score, the score was confirmed to be useful in identifying the high-risk patients and, therefore , to implement cost-effective antimicrobial use.