The impact of antibiotic prophylaxis with cefazolin, and ceftizoxime along with aminoglycosides on postoperative complications, hospitalization, and returning to normal life for percutaneous nephrolithotomy, A prospective cross-sectional study

Abstract

Abstract Objective This study investigated the efficacy of first-generation cephalosporin (cefazolin) and third-generation cephalosporin (ceftizoxime) as prophylactic antibiotics in patients undergoing PCNL surgery. The study also examined the incidence of postoperative complications, hospitalization duration, and return to normal life. Methods This prospective cross-sectional study included patients (≥ 20 years) who underwent PCNL surgery at RAZI, GOLSAR, and PARS Hospitals from January 01, 2013, to December 31, 2022. Patients were divided into two groups and received 1mg/kg of either first-generation (cefazolin) or third-generation (ceftizoxime) intravenously, 30 minutes before the surgery. The incidence of postoperative complications, hospitalization duration, and return to normal life were compared based on the type of prophylactic antibiotic. Risk factors were evaluated using chi-squared tests followed by multivariate logistic regression analysis. Results The ceftizoxime group showed significantly lower rates of general complications (13.0% vs 31.4%) and postoperative fever (2.8% vs 15.0%) compared to the cefazolin group. The ceftizoxime group also had a significantly shorter total hospitalization duration (1.31 ± 1.18 days) compared to the cefazolin group (4.03 ± 1.57 days) (p = 0.000). Additionally, the ceftizoxime group had a significantly shorter duration for return to normal life (5.97 ± 3.37 days) compared to the cefazolin group (8.15 ± 2.93 days) (p = 0.001). Conclusion The third-generation prophylactic cephalosporin (ceftizoxime) was superior to the first-generation (cefazolin) in reducing postoperative fever rates, hospitalization duration, and time to return to normal life for patients.