DOI: 10.36347/sjams.2018.v06i04.050

Pages: 1623-1628

Infection is the one of the most important complication after extracorporeal shock wave lithotripsy (ESWL). Role of antibiotics after ESWL is controversial. We did the study to know the incidence of infectious complications following ESWL and need for post procedural antibiotics in low risk patients. We did a prospective, observational; cohort study from April 2015 to November 2016.Total 162 patients were taken who were advised to undergo ESWL in our Out Patient Department (OPD) for renal or ureteric calculus/calculi. Urine culture was performed 5 days before and 7 days after the procedure. No patients (without any risk factors or negative pre-procedural urine culture) received any post-procedural antibiotics. Total 144 patients were enrolled in the study with median age of 37.58 ± 10.67 years. Among 144 patients, 127 patients (88.2%) had sterile urine culture done 7 days after ESWL. Only in 17 patients (11.8%) patients, urine culture was positive. Out of these 17 culture positive patients, 14 patients(9.7%) had no symptoms(asymptomatic bacteriuria), 3 patients(2.1%) had urgency, frequency, burning micturition, dysuria(symptomatic UTI) and none of the patients developed urosepsis. In our study, we found stone size to be an independent factor for developing infection. The incidence of infectious complications after extracorporeal shock wave lithotripsy is low in patients without risk factors. So, routine antibiotic prophylaxis is not justified without defined risk factors such as positive urine culture before ESWL, an external bladder catheter or nephrostomy tube and a history of infectious stones or recurrent urinary tract infections. Patients with larger stones (>1cm) are more at risk for post-ESWL bacteriuria and, thus, for a possible infectious complication.