Comparison of Ceftriaxone and Cefazolin Sodium Antibiotic Prophylaxis in Terms of SIRS/Urosepsis Rates in Patients Undergoing Percutaneous Nephrolithotomy

Abstract

Objective:The aim of this study is to compare ceftriaxone and cefazoline sodium antibiotic prophylaxis in terms of development of Systemic Inflammatory Response syndrome (SIRS)/urosepsis in patients undergoing percutaneous nephrolithotomy (PCNL).Materials and Methods:Patients who underwent PCNL between June 2015 and October 2015 in our hospital were prospectively randomized to ceftriaxone (n=30) and cefazoline sodium (n=32) antibiotic prophylaxis groups. Patients with predisposing conditions to SIRS were excluded. Intraoperative urine cultures from renal pelvis and stone cultures were obtained from all patients. Clinical and laboratory findings of the patients who developed postoperative fever were evaluated. SIRS and urosepsis rates were compared between two groups.Results:There were 7 patients in ceftriaxone group (23.3%) and 4 patients in cefazoline sodium group (12.5%) who developed SIRS (p=0.264). Sepsis was observed in 2 patients in both groups (p=0.826). Prolonged duration of surgery in ceftriaxone group and renal pelvis urine culture positivity in cefazoline group were found to be statistically significant in patients who developed SIRS (p=0.02, p=0.015, respectively).Conclusion:There was no significant difference between two groups in terms of SIRS and sepsis following PCNL. Therefore, cefazoline, which has a narrower antimicrobial spectrum, may be preferred for prophylaxis.

Keywords

• Prospective
• Percutaneous nephrolithotomy
• Antibiotic prophylaxis
• Systemic Inflammatory Response syndrome
• Sepsis