Presented by Dr. Kari Tikkinen and team at EAU25, the APPEAL trial is the largest randomized controlled study to date evaluating the role of antimicrobial prophylaxis during shock wave lithotripsy (SWL).
Involving 1,694 patients across 12 centers in 9 countries, this double-blind, placebo-controlled study showed that a single dose of ciprofloxacin reduced the rate of bacteriuria/UTI to 2.5% vs 3.5% (placebo). Symptomatic UTIs were halved (1.2% vs 2.5%), and no patients in the antibiotic arm developed pyelonephritis or urosepsis, compared to 8 cases in the placebo group.
While the absolute reduction in infections was small, the findings may support tailored use of antibiotics in high-risk patients—particularly in the context of global antibiotic stewardship.
Thank you to Dr. Tikkinen and collaborators from the University of Helsinki, University of Toronto, Tabriz University of Medical Sciences, and other global institutions for this important contribution.
For more information: https://lnkd.in/dd2yxkK8
