Objective: The objective of this study was to investigate the efficacy of second‑line versus first‑line antibiotics in the prevention of postoperative fever after tubeless percutaneous nephrolithotomy (PCNL).
Methods: Three hundred consecutive tubeless PCNL procedures performed at our hospital between August 2010 and December 2013 were enrolled in this study. The efficacy of second‑line antibiotics in the prevention PCNL‑related urinary traction was reviewed by retrospective chart review.
Results: The overall postoperative fever rate was 12% (36 of 300 procedures). The second‑line antibiotic prophylaxis was provided in 32 procedures according to preoperative urine culture data or physician’s
judgment. The first‑line prophylactic antibiotic was used in 268 procedures with postoperative fever in 29 procedures (10.8%). The second‑line prophylactic antibiotic was used in 32 procedures with postoperative
fever in seven procedures (21.9%). No significance difference of postoperative fever rate between first‑line or second‑line prophylactic antibiotic was found (P = 0.069).
Conclusions: The second‑line prophylactic antibiotic use for tubeless PCNL does not offer additional benefit over the first‑line prophylactic antibiotic in the prevention of postoperative fever or shortening of the
postoperative hospital stay.