Antibiotic prophylaxis in percutaneous nephrostomy placements and replacements for malignant urinary tract obstruction. Retrospective cohort study with systematic review and meta-analysis.

IF 4

Frontiers in radiology Pub Date : 2026-05-19 eCollection Date: 2026-01-01 DOI:10.3389/fradi.2026.1787168

Jeferson Rodrigo Zanon, Thiago Morais Santos, Henrique Durante, Welinton Yoshio Hirai, Marcelo Jenné Mimica, José Humberto Tavares Guerreiro Fregnani, Ricardo Dos Reis

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引用次数: 0

Abstract

Introduction: Percutaneous nephrostomy (PN) can lead to urinary tract infections (UTIs), but these can be prevented by administering antibiotics. However, the effectiveness of this approach is debated.

Methods: To evaluate the association between PN-related UTIs and antibiotic prophylaxis in cancer patients. This is a hybrid study was designed. A retrospective cohort study was conducted on cancer patients requiring PN, comparing antibiotic prophylaxis with no prophylaxis. The outcome, UTI, was measured up to seven days after the procedure. This cohort study was included in a systematic review and meta-analysis, for which random-effects models were used to synthesize the outcomes.

Results: 734 PN procedures were performed. The UTI rate following antibiotic prophylaxis was 0/158 for catheter placement and 3/66 (4.5%; p = 0.025) without prophylaxis. For catheter replacement, the UTI rate was 10/229 (4.4%) with prophylaxis and 2/67 (3.0%; p > 0.999) without. Nineteen studies with 4,606 patients were included. The binary meta-analysis included five studies and this cohort, with an odds ratio (OR) of 0.883 (95% CI = 0.400-1.951; I ² = 50.2%) for UTI. These studies had a moderate to critical risk of bias.

Discussion: Antibiotics may only protect against UTIs during PN catheter placement, but this was not confirmed by the meta-analysis. A randomized clinical trial is needed.

Conclusion: Antibiotics may only protect against UTIs during PN catheter placement, but this was not confirmed by the meta-analysis. A randomized clinical trial is needed.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42021231063, ClinicalTrials.gov NCT06801405 and PROSPERO CRD42021231063.

查看原文本刊更多论文

恶性尿路梗阻经皮肾造口置换术中的抗生素预防。回顾性队列研究，系统评价和荟萃分析。

导读：经皮肾造口术（PN）可导致尿路感染（uti），但这些可以通过使用抗生素来预防。然而，这种方法的有效性存在争议。方法：评价肿瘤患者pn相关性尿路感染与抗生素预防的关系。这是一项混合研究。对需要PN的癌症患者进行了一项回顾性队列研究，比较了抗生素预防和不预防。结果，尿路感染，是在手术后7天测量的。本队列研究纳入系统综述和荟萃分析，随机效应模型用于综合结果。结果：共进行了734例PN手术。抗生素预防后尿路感染发生率置管组为0/158，未预防组为3/66 （4.5%;p = 0.025）。对于导管置换术，预防组尿路感染发生率为10/229(4.4%)，未预防组为2/67 （3.0%;p > 0.999）。纳入了19项研究，共4606例患者。二元荟萃分析包括5项研究和该队列，尿路感染的优势比（OR）为0.883 （95% CI = 0.400-1.951; i2 = 50.2%）。这些研究有中度到严重的偏倚风险。讨论：抗生素可能仅在放置PN导管期间预防尿路感染，但meta分析并未证实这一点。需要随机临床试验。结论：抗生素可能仅在放置PN导管期间预防尿路感染，但meta分析并未证实这一点。需要随机临床试验。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42021231063, ClinicalTrials.gov NCT06801405和PROSPERO CRD42021231063。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in radiology

CiteScore

1.20

自引率

0.00%

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