fosfomycin and Kidney-Calculi

This study sought to evaluate the antibacterial effect of fosfomycin tromethamine (FT) on the bacteria inside urinary infection stones.. The internal structures of urinary stones were observed via scanning electron microscopy to verify the presence of internal bacteria. We randomly assigned equal numbers of patients with kidney stones who met the inclusion criteria into two groups in a prospective study and treated them with different perioperative antibiotics. One group (experimental group) was treated with FT, and the other (control group) was treated with cefuroxime sodium. All stone specimens were collected via percutaneous nephrolithotomy (PCNL). The primary infection stones were screened via a stone component analysis, 30 cases in the experimental group and 31 cases in the control group. High-performance liquid chromatography (HPLC)-mass spectrometry was used to measure the drug concentration inside the stones, the bacterial count was calculated via stone culture, and the clinical infection index were monitored for between-group comparisons.. Compared with the control group, the experimental group had a higher internal drug concentration, a higher drug sensitivity against various pathogenic bacteria, a lower bacterial colony count in the stone culture, and a lower incidence of postoperative clinical infection.. FT is more effective than cefuroxime, which is commonly used during the perioperative period of urinary stones, and exerts a high antibacterial effect on these internal bacteria, and effectively reduces the probability of infection and sepsis after urinary stone surgery. FT can be used as an antibiotic during the perioperative period of urinary stones.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria; Cefuroxime; Colony Count, Microbial; Female; Fever; Fosfomycin; Humans; Kidney Calculi; Male; Middle Aged; Nephrolithotomy, Percutaneous; Postoperative Complications; Prospective Studies; Sepsis

In this study, we aimed to show the protective effect of a single-dose Fosfomycin from infective complications against the standard usage of cephalosporine before retrograde intrarenal surgery.. A total of 186 patients who underwent retrograde intrarenal surgery between 2020 and 2021, included the study. Patients were divided into two groups: group 1(n=49), patients who received an oral dose of 3g Fosfomycin tromethamine powder administered 4-6h before the operation; and group 2 (n=137): patients who received Cephalosporin 30min before surgery and an additional dose 6h after surgery.. The median age and stone size were significantly higher in the cephalosporin group (P=0.006 and P=0.008, respectively). There was no statistically significant difference between the groups in terms of postoperative fever and postoperative UTI (P=0.408 and P=0.438). Additionally, no patient developed sepsis. and no adverse event was seen in either group. Preoperative urinary tract infection (UTI) and previous Extracorporeal Shock Wave lithotripsy (ESWL) were independent risk factors and increased postoperative infectious complications (O.R. 2.929 95% C.I. 0.723, P<0.001, and O.R. 2.860 95% C.I. 0.985, P=0.004, respectively).. Infectious is still one of the important complications after RIRS, and preoperative UTI is an independent risk factors for infections. Fosfomycin monotherapy could be sufficient and is also effective in patients with preoperative culture positive.

Topics: Cephalosporins; Fosfomycin; Humans; Kidney Calculi; Lithotripsy; Monobactams; Postoperative Complications; Prospective Studies; Retrospective Studies; Treatment Outcome; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Cephalosporins; Endoscopy; Fosfomycin; Humans; Kidney Calculi; Nephrostomy, Percutaneous

Authors have carried out a retrospective study in vitro on the bacteria isolated from renal parenchyma and stones in patients with CPN associated to kidney stones. Results show a different inhibitory action of the some antibiotics to Proteus, E. coli and P. aeruginosa. Fosfomycin inhibits the growth of bacteria in a wide range of concentration (50-1000 microgram/ml). A prospective study in vivo shows an excellent therapeutic action of fosfomycin in recurrent urinary infections, and a very good one in CPN and in some forms associated to kidney stones.

Topics: Adult; Aged; Anti-Bacterial Agents; Chronic Disease; Dose-Response Relationship, Drug; Escherichia coli; Female; Fosfomycin; Humans; Kidney Calculi; Male; Middle Aged; Proteus; Pseudomonas aeruginosa; Pyelonephritis