Antimicrobial prophylaxis for ureterorenoscopic surgery


  • Shreeharsha Mallappa Awati Department of Urology, Sanjay Gandhi Institute of Trauma and Orthopedics, Byrasandra, Jayanagar, Bengaluru, Karnataka


Antimicrobial prophylaxis, Endourology, Ureterorenoscopy, Urinary tract infection


The necessity of antimicrobial prophylaxis (AMP) for ureterorenoscopy is undisputed. Most guidelines state that single AMP is sufficient for ureteroscopy, but indiscriminate antibiotic use is common. Except for transurethral resection of prostate and prostate biopsy, there is a lack of well-performed studies investigating the need and duration of antibiotic prophylaxis in endourology. Although single dose AMP is a widely accepted principle, still multiple-dose regimens are used in some centers. A systematic review was done to know the AMP for ureteroscopy using PubMed articles and Urological Association guidelines. It was concluded that a single dose AMP is necessary for ureterorenoscopic surgery. Either a fluoroquinolone or a combination of ampicillin and aminoglycoside can be used as prophylactic antibiotic.


Grabe M, Botto H, Cek M, Tenke P, Wagenlehner FM, Naber KG, et al. Preoperative assessment of the patient and risk factors for infectious complications and tentative classification of surgical field contamination of urological procedures. World J Urol. 2012;30(1):39-50.

Knopf HJ, Graff HJ, Schulze H. Perioperative antibiotic prophylaxis in ureteroscopic stone removal. Eur Urol. 2003;44(1):115-8.

Moslemi MK, Movahed SM, Heidari A, Saghafi H, Abedinzadeh M. Comparative evaluation of prophylactic single-dose intravenous antibiotic with postoperative antibiotics in elective urologic surgery. Ther Clin Risk Manag. 2010;6:551-6.

Bootsma AM, Laguna Pes MP, Geerlings SE, Goossens A. Antibiotic prophylaxis in urologic procedures: A systematic review. Eur Urol. 2008;54(6):1270-86.

McDonald M, Grabsch E, Marshall C, Forbes A. Single- versus multiple-dose antimicrobial prophylaxis for major surgery: A systematic review. Aust N Z J Surg. 1998;68(6):388-96.

Schaeffer AJ, Schaeffer EM. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 9th Edition. Philadelphia: Saunders; 2007: 223-303.

Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K, et al. Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol. 2007;14(10):890-909.

Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179(4):1379-90.

Kau EL, Ng CS, Fuchs GJ. Complications of ureteroscopic surgery. In: Taneja SS, editor. Complications of Urologic Surgery: Prevention and Management. 4th Edition. Philadelphia: Saunders; 2010: 303-16.

Wolf JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearls MS, Schaeffer AJ. Best practice policy statement on urologic surgery antimicrobial prophylaxis. AUA Updates, 2008.

Naber KG, Schaeffer AJ, Hynes CF, Matsumoto T, Shoskes DA, Bjerklund Johansen TE, editors. EAU/International Consultation on Urological Infections. EAU Updates 2011. The Netherlands: European Association of Urology; : 78-110.

Takahashi S, Takeyama K, Miyamoto S, Tanuma Y, Takagi Y. Surgical antimicrobial prophylaxis in transurethral ureterolithotripsy. J Infect Chemother. 2005;11(5):239-43.

Shigemura K, Arakawa S, Yamashita M, Yasutuku T, Fujisawa M. Surgical site infections may be reduced by shorter duration of prophylactic antibiotic medication in urological surgeries. Jpn J Infect Dis. 2009;62(6):440-3.

Higuchi Y, Takesue Y, Yamada Y, Ueda Y, Suzuki T, Aihara K, et al. A single-dose regimen for antimicrobial prophylaxis to prevent perioperative infection in urological clean and clean-contaminated surgery. J Infect Chemother. 2011;17(2):219-23.

Yamamoto S, Mitsui Y, Ueda Y, Suzuki T, Higuchi Y, Qiu J, et al. Assessment of single-dose regimen for antimicrobial prophylaxis to prevent perioperative infection in urologic surgery. Hinyokika Kiyo. 2008;54(9):587-91.

Grabe M. Perioperative antibiotic prophylaxis in urology. Curr Opin Urol. 2001;11(1):81-5.

Zanetti G, Paparella S, Trinchieri A, Prezioso D, Rocco F, Naber KG. Infections and urolithiasis: Current clinical evidence in prophylaxis and antibiotic therapy. Arch Ital Urol Androl. 2008;80(1):5-12.

Shokeir AA, Al Ansari AA. Iatrogenic infections in urological practice: Concepts of pathogenesis, prevention and management. Scand J Urol Nephrol. 2006;40(2):89-97.

Esposito S. Is single-dose antibiotic prophylaxis sufficient for any surgical procedure? J






Review Articles