Antibiotic prophylaxis in children with ureteric stents: Bliss or misery?
Basim S Alsaywid1, Abdullah A Mesawa2, Abdullah Khalid Mohammedkhalil2, Mohammed Almarghoub3, Zhour Barnawi4, Wesam T Abuznadah5
1 Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City; Department of Academic Affairs, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
2 Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
3 Department of Academic Affairs, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
4 Department of Academic Affairs, College of Medicine, Um Al-Qura University, Makkah, Saudi Arabia
5 Department of Academic Affairs, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
Dr. Abdullah Khalid Mohammedkhalil
Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, P.O. Box 2407, Jeddah 21451
Introduction: The risk of urinary tract infection (UTI) in patients with a ureteric stent is influenced by several factors such as duration of stenting. Antibiotic prophylaxis has been previously used for the prevention of UTI in patients with common urological pathologies. The aims of this study were to evaluate the incidence, to identify the risk factors of symptomatic UTI in pediatric patients with ureteric stents, and to review the effectiveness of antibiotic prophylaxis in reducing the rate of symptomatic UTI compared to a no intervention (control) group.
Materials and Methods: This was a retrospective cohort study that was held at a tertiary hospital in Jeddah, Saudi Arabia. The study included 110 pediatric patients who were younger than 18 years and who required ureteric stent insertion. Disregarding gender difference, the patients were divided into two main groups: an antibiotic group and a control group. The patients in the antibiotic group (Group 1) received continuous antibiotic prophylaxis from the date of ureteral stent insertion until removal, while the patients in the control group (Group 2) received antibiotics during the perioperative period only.
Results: A total of 110 patients were included in the final analysis. Group 1 patients who were given antibiotic prophylaxis during the presence of ureteric stent were 54 patients (49%). Group 2 patients who were only given antibiotic during the perioperative period were 56 (51%). Males compromised 73% (n = 80) of the sample population, while females were 27% (n = 30). The prevalence of symptomatic UTI was significantly reduced from 25% in the control group to 7% in the antibiotic group (P < 0.004).
Conclusion: Antibiotic prophylaxis has significantly reduced the risk of symptomatic UTI by 68% in comparison to the control group.