THE EFFECTIVENESS OF METAPHYLAXIS OF NEPHROLITHIASIS DURING PERCUTANEOUS NEPHROLITHOTRIPSY: A SYSTEMATIC REVIEW AND METAANALYSIS.
Bibliographic record
Abstract
RELEVANCE: Infected kidney stones, particularly struvite and carbonate-apatite calculi, pose a serious medical challenge due to recurrent urinary tract infections, rising antibiotic resistance, and complications following percutaneous nephrolithotripsy (PCNL). AIM: To assess the effectiveness of metaphylaxis of infected kidney stones, investigate their composition, analyse antibiotic resistance, and determine the incidence of infectious complications after percutaneous nephrolithotripsy. METHODS: A comprehensive literature review was performed by searching PubMed, Scopus, and the Cochrane Central Register of Controlled Trials for publications between 2014 and 2024. The search strategy was built around key phrases such as 'infected kidney stones,' 'metaphylaxis,' 'antibiotic resistance,' 'percutaneous nephrolithotripsy,' and 'struvite stones.' Clinical trials, cohort and case-control studies with at least 20 participants were included; animal studies and case reports were excluded. Study selection was conducted by two independent reviewers. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Forty-seven studies from 23 countries (n=8342) were analysed. Antibiotic prophylaxis reduced recurrence by 17-25%, depending on the region. Struvite stones accounted for 67.3%, with associations to Proteus mirabilis (38.4%) and Escherichia coli (29.6%). Antibiotic resistance reached 43.2%, with peaks for ampicillin (71%) and ciprofloxacin (48%). Complications after PCNL occurred in 12-28% of cases, including sepsis (3.4%) and pyonephrosis (7.8%). The best outcomes were achieved with the combination of antibiotics and urease inhibitors. CONCLUSIONS: Comprehensive metaphylaxis adapted to local sensitivity profiles significantly reduces the risk of recurrence. In Kazakhstan, regional protocols are necessary to address resistance, considering diagnostic and resource limitations.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.039 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.035 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".