Using Gram Stain of the First Urine After Kidney Puncture to Predict Inflammation After Percutaneous Nephrolithotomy

What this Trial Is About

Researchers are investigating the use of Gram staining of the first urine collected after kidney puncture during percutaneous nephrolithotomy PCNL to predict systemic inflammatory responses in patients undergoing this procedure. The study compares patients receiving an expanded empirical antibiotic regimen based on the Gram stain results to those whose antibiotic treatment is adjusted later according to symptoms and culture outcomes. The goal is to evaluate the diagnostic value of Gram stain in anticipating and preventing post-surgical complications. Participants are randomly assigned to one of two groups the experimental group receives antibiotic treatment guided by Gram staining of the first urine after the renal puncture, while the control group undergoes PCNL without this intervention, relying on standard care and symptom-based antibiotic adjustments. This is a prospective, randomized controlled study with triple masking to reduce bias. During the study, researchers will assess the effectiveness of Gram stain in predicting systemic inflammatory responses immediately after surgery and monitor changes in antibiotic regimens based on bacterial findings. Patients will be observed for signs of inflammation and infection, with data collected promptly post-operation to evaluate the impact of the diagnostic approach on clinical outcomes and antibiotic use.

Gram Stain of the First Urine After Puncture in Percutaneous Nephrolithotomy