Effects Of Different Doses Of Antibiotics On URL And FURL Infection In Patients With Ureteric Calculi With Negative Urine Culture And Positive Leucocyte Under High Power Urine Microscopy

Objective:To compare and analyze the effects of different doses of antibiotics on URL and FUL postoperative infection in patients with ureteral calculi with negative urine culture and positive white blood cells under high magnification urine microscopy,and explore the impact of different doses of antibiotics before and during the perioperative period on the risk of postoperative infection.Methods: A total of 86 ureteral calculi patients with negative urine culture and≥10 white blood cells/field at high magnification were enrolled in this prospective randomized controlled trial from December 2020 to December 2022 in the Department of Urology,the First Affiliated Hospital of Hainan Medical University.The samples were divided into two groups according to 1:1 simple random method.Group 1 was the single dose group,which was given 1g of cefmetazole sodium for intravenous antibiotic injection 30 minutes before surgery for once.Group 2 Multi-dose group was given cefmetazole sodium 1g twice a day for 3 days before surgery.If the patient has infectious complications during or after surgery,antibiotic use should be upgraded or prolonged,the decision should be made according to the change of the disease.The patient data of the two groups were prospectively analyzed,and the preoperative general situation,stone location,stone size and hydronephrosis of the two groups were compared.Preoperative and postoperative leukocyte,neutrophil ratio,procalcitonin,hypersensitive C-reflecting protein,hemoglobin,creatinine,operative time,postoperative complications and other data.Results: There were no significant differences in age,gender,BMI,preoperative urinary white blood cells,preoperative neutrophil percentage,preoperative hypersensitive C protein,preoperative procalcitonin,preoperative creatinine,history of hypertension,previous surgical history,stone type,location,diameter,and degree of hydronephrosis among the 86 patients included in the study(P>0.05).There were statistically significant differences in postoperative white blood cell count,postoperative neutrophil percentage,postoperative procalcitonin,postoperative maximum body temperature and postoperative SISR incidence(P<0.05),while there were no statistically significant differences in postoperative urinary white blood cells,operative time,postoperative creatinine,postoperative heart rate and postoperative stone clearance rate(P>0.05).Conclusion: With the exclusion of relevant risk factors before surgery,the use of antibiotics 3 days before surgery can reduce the incidence of postoperative SISR in patients with ureteral calculi with negative urine culture and positive white blood cells under high power microscope requiring FURL and URL,effectively prevent the occurrence of postoperative infection and benefit the patients.