Confirmation of negative urine culture status after appropriate antibiotic treatment prior to endourological stone procedures: Is it really necessary?

Urolithiasis. 2024 Feb 8;52(1):30. doi: 10.1007/s00240-023-01524-5.

Abstract

To evaluate the necessity of confirmation for a negative urine culture test outcome after an appropriate antibiotic regimen for urinary tract infection (UTI) prior to endoscopic stone removal procedures. 170 cases receiving an appropriate antibiotic treatment for culture proven UTI based on test outcomes before endoscopic stone removal were evaluated in two groups: Group 1 (n = 85) Patients in whom a second urine culture test was performed to ensure "negative urine culture" status prior to the procedures after receiving antibiotic therapy and Group 2 (n = 85). Patients receiving the same antibiotic therapy without any additional urine culture test before the procedures. Cases were comparatively evaluated with respect to the statistical significance of post-operative infective complications (fever, sepsis), duration of hospital stay and readmission rates during early post-operative period. Our findings demonstrated no significant difference regarding the rate of infective complications (presence of fever, incidence of septic findings), hospitalization period and readmission rates between the two groups. Although the presence of a negative urine status has been confirmed by urine culture test in group 1 cases, no additional urine culture test was performed with this aim in group 2 cases (negative urine culture was confirmed only with urinalysis) and the outcomes regarding the infective problems were found to be similiar. Our current findings indicate that a second urine culture test may not be a "must" if the patients receive an appropriate antibiotic regimen based on the sensitivity test outcomes for a reasonable time period.

Keywords: Flexible ureteroscopy; Negative urine culture; Post-operative infective complication; Urinary tract infection; Urine culture test.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Kidney Calculi* / surgery
  • Postoperative Complications
  • Retrospective Studies
  • Urinalysis
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / etiology

Substances

  • Anti-Bacterial Agents