Percutaneous nephrolithotomy

Note: If positive urine culture pre-operatively, institute treatment according to culture and susceptibility results.

 

Common Pathogens

Enterobacteriaceae
Pseudomonas spp
Enterococcus spp


Regimen(s) of Choice
See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration
Oral regimens: (give 1-2h pre-op)
Ciprofloxacin 500mg PO x 1 pre-op dose
or    
Co-trimoxazole 1 DS tablet PO x 1 pre-op dose

or

   
Parenteral regimens:
Ceftriaxone 1g IV x 1 pre-op dose
or    
Gentamicin 1.5mg/kg IV x 1 pre-op dose

Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS])
Oral regimens: (give 1-2h pre-op)
Ciprofloxacin 500mg PO x 1 pre-op dose
or    
Co-trimoxazole 1 DS tablet PO x 1 pre-op dose

or

   
Parenteral regimen:
Gentamicin 1.5mg/kg IV x 1 pre-op dose