The role of antibiotics in patients with increased risk of infection during extracorporeal shock wave lithotripsy (ESWL) treatment

Abstract

Objective. In this prospective, randomized study, the incidence of urinary tract infections following extracorporeal shock wave lithotripsy (ESWL) in a high risk population and effectiveness of two different antimicrobial agents were evaluated. Methods: A total of 56 patients with renal and ureteric stones who had increased risk of infection before ESWL treatment received either 200 mg of Ofloxacin or trimethoprim-sulfamethaxazole (TM+SMZ) 160/400 mg. bid. Patients were followed by simple urine analysis, urine cultures and blood cultures if necessary together with clinical evaluations. Results: Three patients (5.4%) had positive urine cultures one week after ESWL. The incidence of positive cultures was 40% in patients who had asymptomatic bacteriuria before ESWL. Conclusion: The urine should be sterilized by appropriate antibiotic administration before initiation of ESWL therapy in patients with bacteriuria to prevent infectious complications.