This was a retrospective observational study of patients admitted with obstructive infected kidney stone(s) at The Ottawa Hospital (TOH), Ontario, Canada. Patients 18 years of age or older, with a stent or a percutaneous nephrostomy tube and treated with either a 10 to 14-day course of antibiotics (+/- 2 days) followed by an antibiotic-free period until stone removal (group 1) or a longer continuous course of antibiotics until stone removal (+/- 2 days) (group 2) were included. The primary endpoint was recurrence of infection.
Study results suggest that a continuous course of antibiotics until definitive stone management may be beneficial in patients with an obstructive infected stone, or a subset thereof. Due to lack of power, the subgroup of patients, if any, that may benefit from a continuous course of antibiotics until stone removal could not be determined. This study provides an impetus to conduct a larger trial to confirm our findings, explore characteristics to identify which patients may benefit most from a continuous antibiotic course and/or test the hypothesis that the number of antibiotic-free days before definitive stone removal is a driving factor for recurrent infections.
Presented by Luke Witherspoon, MD, Department of Urology, University of Ottawa, Canada
Co-Authors: Lizanne Béïque, Rosemary Zvonar, Kathryn Suh, Janet Squires, Matthew Roberts, Neal Rowe, James Watterson, Caroline Nott
Written by Luke Witherspoon and Zhamshid Okhunov, Twitter: @jwatterson8 and @OkhunovZham, Department of Urology, University of California-Irvine