From the FDA Drug Label
Aztreonam has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE5 section Aerobic Gram-negative microorganisms: Citrobacter species Enterobacter species Escherichia coli Haemophilus influenzae (including ampicillin-resistant and other penicillinase-producing strains) Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia species
Broad spectrum antibiotics for the management of staghorn calculi include:
These antibiotics have been shown to be effective against a variety of Gram-negative microorganisms, which are commonly associated with urinary tract infections, including those that can cause staghorn calculi. However, the choice of antibiotic should be based on the specific causative organism and its susceptibility pattern.
From the Research
Broad-spectrum antibiotics, such as fluoroquinolones or third-generation cephalosporins, are recommended for the management of staghorn calculi to prevent infection and sepsis, as supported by the most recent guideline from the International Alliance of Urolithiasis (IAU) 4.
Key Considerations
- The choice of antibiotic should be guided by urine culture and sensitivity testing to ensure adequate coverage against common causative organisms such as Proteus, Klebsiella, Pseudomonas, and Staphylococcus species.
- Treatment should begin before any surgical intervention and continue for 1-2 weeks postoperatively to minimize the risk of sepsis and recurrent infections.
- Patients should maintain adequate hydration and follow-up urine cultures to ensure infection eradication.
Recommended Antibiotics
- Fluoroquinolones (such as ciprofloxacin 500mg twice daily or levofloxacin 500mg once daily)
- Third-generation cephalosporins (like ceftriaxone 1-2g daily)
- Aminoglycosides (such as gentamicin 5mg/kg daily) combined with ampicillin
Importance of Antibiotic Coverage
- Staghorn calculi are often associated with urinary tract infections caused by urea-splitting organisms, which can lead to sepsis and recurrent infections if not properly treated.
- Adequate antibiotic coverage is crucial to prevent these complications and ensure successful management of staghorn calculi, as highlighted in a study on the management of staghorn renal stones 5.
Additional Recommendations
- Patients with staghorn calculi should be closely monitored for signs of infection and sepsis, and treated promptly if symptoms occur.
- Regular follow-up urine cultures and imaging studies should be performed to ensure infection eradication and prevent stone regrowth, as recommended in a study on the conservative management of staghorn calculi 6.