0 items found

992: Tailored optimal perioperative antimicrobial prophylaxis in retrograde intrarenal surgery: Evidence from a prospective randomized trial

G. Zeng, Guangzhou (CN)
Zeng G.
The First Affiliated Hospital of Guangzhou Medical University, Dept. of Urology, Guangzhou, China, 0
33rd Annual EAU Congress Copenhagen
Date – time - Location
19 March 2018, 14:00 - 15:30, Green Area, Room 1 (Level 0)
Poster Session 73 - Safe access through natural orifice: It is the era of ureteroscopy
Stones: Ureteroscopy

Introduction & Objectives

To present a prospective randomize trail in comparison of multiple-, single-, zero-dose antibiotic prophylaxis in RIRS, and investigate the ideal protocol for antibiotic prophylaxis in RIRS.

Materials & Methods

A prospective randomized trial was conducted between August 2014 and November 2016. 300 consecutive patients with preoperative sterile urine undergoing RIRS were randomized into three groups and received ciprofloxacin-based different ABP regimes (group 1, zero-dose; group 2, single dose, 30 min before the surgery; group 3, two doses, first dose at 30 min before the surgery and additional dose within 12 hours after surgery. The primary endpoint was the systemic inflammatory response syndrome (SIRS).


A total of 265 patients (group 1: 88, group 2: 88, group 3:89) were eligible for final analysis. Baseline characteristics were similar between three groups. SIRS was recorded in 8 (9.1%), 3 (3.4%) and 1(1.2%) patients in group 1, 2, 3, respectively. In subgroup analysis, SIRS occurred respectively in 5.0%, 5.1% and 0% of patients with stones ≤ 200 mm2; for stones > 200 mm2, low rates of SIRS were still observed in group 2 (0%) and group 3 (2.7%), however, 17.9% were developed in group 1. No urosepsis was developed in any groups.


RIRS without antibiotic prophylaxis is safe for patients with with preoperative sterile urine and stones ≤200 mm2, and prophylactic antibiotics are not recommended for those patients. However, single dose prophylaxis seems necessary and sufficient for patients with stones >200 mm2.