Introduction: There is no specific recommendation for postoperative antibiotic regimen in patients undergoing percutaneous nephrolithotomy (PCNL). The aim of this study is to perform a high quality meta-analysis using only randomized controlled trials (RCT) trials to define the role of postoperative antibiotics in patients undergoing PCNL. Methods: This review was conducted according to PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. A search for "percutaneous nephrolithotomy" and "antibiotic" was performed on EMBASE, PubMed and Web Of Science platforms, resulting in 1362 publications. We selected only RCT that compared short dose perioperative vs. postoperative antibiotic prophylaxis in patients undergoing PCNL. The PICO (population, intervention, control and outcome) was: Population - adult patients that underwent to PCNL; Intervention - postoperative antibiotic prophylaxis; Control - short dose perioperative antibiotic prophylaxis; and Outcome - systemic inflammatory response syndrome (SIRS) or sepsis and fever after PCNL. The meta-analysis protocol was registered on PROSPERO database (CRD42022361579). Risk of bias assessments were done independently by 2 of the investigators with agreement, without discrepancy. We calculated odds ratios (OR) and 95% confidence interval (CI) of each study to evaluate differences between them. Chi-squared test and I2 were used to evaluate heterogeneity. When heterogeneity was present, random effects model was used. Alpha risk was defined as < 0.05. Results: The final selection was seven articles with a total of 629 patients studied. Forest plots (figure 1) evidenced there was no statistical association between use of postoperative antibiotic prophylaxis and SIRS/sepsis (OR 1.204, 95% CI 0.719 – 2.016, p = 0.481). Patients who received intervention had higher fever incidence (OR 2. 048, 95% 1.038 – 4.040, p = 0.039) than control group. Conclusions: We conclude that there is no benefit in the use of postoperative antibiotic prophylaxis in patients undergoing PCNL. SOURCE OF Funding: None.
.jpeg.jpg "Thalita Bento Talizin, MD,MSC photo")
