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The antibiotic strategies during percutaneous nephrolithotomy in China revealed the gap between the reality and the urological guidelines

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机构: [1]Guangzhou Med Univ, Affiliated Hosp 2, Dept Urol, 250 Changgang Rd, Guangzhou 510260, Guangdong, Peoples R China [2]Guangzhou Med Univ, Guangdong Key Lab Urol, Guangzhou, Peoples R China [3]Zhejiang Univ, Sir Run Run Shaw Hosp, Coll Med, Dept Urol, Hangzhou, Peoples R China [4]Capital Med Univ, Beijing Tongren Hosp, Dept Urol, Beijing, Peoples R China [5]Guangzhou Med Univ, Affiliated Hosp 5, Dept Urol, Guangzhou, Peoples R China [6]Guangzhou Med Univ, Affiliated Hosp 1, Dept Urol, 1 Kangda Rd, Guangzhou 510230, Guangdong, Peoples R China [7]Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Urol, Stockholm, Sweden [8]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Sch Med, Dept Urol, Shanghai, Peoples R China [9]Shanghai Jiao Tong Univ, Peoples Hosp 1, Shanghai Gen Hosp, Dept Urol, Haining Rd 100, Shanghai 200080, Peoples R China
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关键词: Percutaneous nephrolithotomy Antibiotic Current practice Guideline Survey

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Background Correct perioperative antibiotic strategies are crucial to prevent postoperative infections during percutaneous nephrolithotomy (PCNL). We aimed to compare the realistic antibiotic strategies applied in China with current urological guidelines. Methods Between April and May 2020, urologists from China were invited to finish an online cross-sectional survey. The questionnaire was designed according to the current urological guidelines and literatures. Results 3393 completed responses were received. 61.1% (2073/3393) respondents had urological experience of more than 10 years. 72.4% urologists chose multiple-dose antibiotics for patients with both negative urine culture (UC-) and negative urine microscopy (UM-) preoperatively. Respondents in central China (OR = 1.518; 95% CI 1.102-2.092; P = 0.011), east China (OR = 1.528; 95% CI 1.179-1.979; P = 0.001) and northeast China (OR = 1.904; 95% CI 1.298-2.792; P = 0.001) were more likely to prescribe multiple-dose antibiotic for UC-UM- patients. Notably, the respondents who finished PCNL exceeded 100 cases per year were in favor of single-dose administration (OR = 0.674; 95% CI 0.519-0.875; P = 0.003). There are only 8.3% urologists chose single-dose antibiotic for UC-UM+ patients, whereas 65.5% administered antibiotics for 1-3 days. Meanwhile, for UC+ patients, 59.0% of the urologists applied antibiotics shorter than 1 week, and only 26.3% of the urologists carried out routine re-examination of UC. Moreover, postoperative antibiotics were frequently prescribed for 3-6 days (1815; 53.5%). Finally, although 88.2% urologists considered stone culture important for management of postoperative antibiotics as the guideline recommended, only 18.5% performed it routinely. Conclusions The antibiotic strategies are different between current practice in China and the urological guidelines. The dissimilarities suggested that further studies should be conducted to investigate the reasons of the differences and standardize the application of antibiotics.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 泌尿学与肾脏学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 泌尿学与肾脏学
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出版当年[2020]版:
Q3 UROLOGY & NEPHROLOGY
最新[2023]版:
Q3 UROLOGY & NEPHROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Guangzhou Med Univ, Affiliated Hosp 2, Dept Urol, 250 Changgang Rd, Guangzhou 510260, Guangdong, Peoples R China [2]Guangzhou Med Univ, Guangdong Key Lab Urol, Guangzhou, Peoples R China
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通讯机构: [1]Guangzhou Med Univ, Affiliated Hosp 2, Dept Urol, 250 Changgang Rd, Guangzhou 510260, Guangdong, Peoples R China [2]Guangzhou Med Univ, Guangdong Key Lab Urol, Guangzhou, Peoples R China [6]Guangzhou Med Univ, Affiliated Hosp 1, Dept Urol, 1 Kangda Rd, Guangzhou 510230, Guangdong, Peoples R China [8]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Sch Med, Dept Urol, Shanghai, Peoples R China [9]Shanghai Jiao Tong Univ, Peoples Hosp 1, Shanghai Gen Hosp, Dept Urol, Haining Rd 100, Shanghai 200080, Peoples R China
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