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CompletedNCT06801405Updated May 19, 2026Results posted

Antibiotic Prophylaxis in Percutaneous Nephrostomy Placements and Replacements for Malignant Urinary Tract Obstruction

An observational study in Ureteral Obstruction, Neoplasms and Acute Kidney Injury, sponsored by Barretos Cancer Hospital. Completed at 1 site in Brazil. Per ClinicalTrials.gov, last updated 2026-05-19.

Sponsored by Barretos Cancer Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
320
Sex
All
01

Study summary

This study aims to find out whether taking antibiotics to prevent a urinary tract infection after a medical procedure called percutaneous nephrostomy (placement of a catheter directly into the kidney to keep it working after the urinary tract has been blocked by a malignant tumour) actually prevents a urinary tract infection, compared to not taking antibiotic prophylaxis.

Read the detailed description

The medical records of cancer patients who underwent percutaneous nephrostomy between January 2013 and July 2020 were reviewed. Procedures were excluded if the nephrostomy was used for other procedures (e.g. double-J passage) or for non-malignant urinary tract obstruction (e.g. kidney stones). The association between antibiotic prophylaxis and UTI was assessed using association tests such as Pearson's chi-squared or Fisher's exact test. A significant level of 5% was adopted.

Definitions:

Urinary tract infection - occurs when there are signs and symptoms consistent with a local infection (fever, chills, dysuria, lower back pain, and costovertebral angle tenderness), such as cystitis (bladder or lower UTI) or pyelonephritis (kidney or upper UTI), combined with a positive urine culture (more than 104 colony-forming units of microorganisms per millilitre of urine with a catheter present or more than 105 colony-forming units of microorganisms per millilitre of urine without a catheter present).

UTI related to percutaneous nephrostomy procedure - occurs until seven days after the percutaneous nephrostomy procedure, both for first placement and/or catheter replacement.

UTI related to the nephrostomy catheter - occurs at another time, usually within 90 days of the procedure, in the presence of the nephrostomy catheter, and in the absence of another focus that would justify the infection.

Antibiotic prophylaxis was administered before percutaneous nephrostomy. If there was no record of antibiotics in the cost centre of the institution's database, it was considered that antibiotic prophylaxis was not given.

For the first percutaneous nephrostomy catheter placement, antibiotic prophylaxis was given empirically.

For catheter replacement, antibiotic prophylaxis was both empirical and targeted, based on the result of a pre-procedure urine culture to guide the antibiotic choice.

Percutaneous nephrostomies (first placement and/or catheter replacement) were excluded from analysis if patients were treated for UTI up to 7 days before or during the procedure. However, they were included in analysis outside the period of antibiotic prophylaxis for future UTIs.

02

Conditions studied

  • Ureteral Obstruction
  • Neoplasms
  • Acute Kidney Injury
  • Nephrostomy; Complications
  • Antibiotic Prophylaxis
  • Urinary Tract Infections

Keywords

  • antibiotic prophylaxis
  • percutaneous nephrostomy
  • urinary tract infections
  • cancer patients
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients treated for cancer who required percutaneous nephrostomies

Inclusion criteria

  • Patients treated for cancer who required percutaneous nephrostomies

Exclusion criteria

Exclusion Criteria:

  • Patients and/or procedures if percutaneous nephrostomy was used to perform other procedures;
  • Patients and/or procedures if percutaneous nephrostomy was used to treat clinical conditions other than malignant ureteral obstruction
  • Patients and/or procedures if percutaneous nephrostomy was used to clear the urinary tract of non-malignant causes
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
320 participants (actual)
Patient registry
No

Groups and cohorts

  • No antibiotic prophylaxis (NAP) - Group

    No antibiotic prophylaxis before percutaneous nephrostomy

  • Antibiotic prophylaxis (AP) - Group

    With antibiotic prophylaxis before percutaneous nephrostomy

    Drug: antibiotic prophylaxis

Interventions

  • Drugantibiotic prophylaxis

    Antibiotic prophylaxis before percutaneous nephrostomy

05

What researchers measure

Primary outcomes

  1. Urinary Tract Infection After Percutaneous Nephrostomy Procedure

    Proportion of urinary tract infection after each percutaneous nephrostomy

    Time frame: Up to 7 days after percutaneous nephrostomy

06

Results

Posted May 19, 2026
Limitations and caveats
Our main limitation is the observational design, which, despite all the precautions taken, still carries a high risk of selection bias in the population

Participant flow

Data were collected on age, sex, skin colour, number of percutaneous nephrostomies performed, including first placements and catheter replacements. The time spent ill and using the nephrostomy catheter was calculated.

Participant flow — Overall Study
MilestoneNo Antibiotic Prophylaxis (NAP) - GroupAntibiotic Prophylaxis (AP) - Group
Started66153
Completed66153
Not completed00

Outcome measures

PrimaryUrinary Tract Infection After Percutaneous Nephrostomy Procedure

Proportion of urinary tract infection after each percutaneous nephrostomy

Time frame:
Up to 7 days after percutaneous nephrostomy
Reported as:
Count of units · Percutaneous nephrostomy procedure
Urinary Tract Infection After Percutaneous Nephrostomy Procedure
Percutaneous nephrostomy procedureNo Antibiotic Prophylaxis (NAP) - GroupAntibiotic Prophylaxis (AP) - Group
Urinary Tract Infection After Percutaneous Nephrostomy Procedure510
Statistical analysis
  • No Antibiotic Prophylaxis (NAP) - Group vs Antibiotic Prophylaxis (AP) - Group · Fisher Exact · p = 0.548

Adverse events

Collected over From enrollment until end of follow-up, an average of 1 week.. Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
No Antibiotic Prophylaxis (NAP) - Group53/66 (80.3%)0/66 (0%)0/66 (0%)
Antibiotic Prophylaxis (AP) - Group127/153 (83%)0/153 (0%)0/153 (0%)

Baseline characteristics

The use of antibiotic prophylaxis is generally recommended by institutional protocol.

Age, Continuous
Age, Continuous(year-old)No Antibiotic Prophylaxis (NAP) - GroupAntibiotic Prophylaxis (AP) - GroupTotal
Median54.37 (42.22 to 64.73)60.27 (49.45 to 70.19)59.04 (45.51 to 68.79)
Sex: Female, Male
Sex: Female, Male(Participants)No Antibiotic Prophylaxis (NAP) - GroupAntibiotic Prophylaxis (AP) - GroupTotal
Female4687133
Male206686
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)No Antibiotic Prophylaxis (NAP) - GroupAntibiotic Prophylaxis (AP) - GroupTotal
Hispanic or Latino000
Not Hispanic or Latino42103145
Unknown or Not Reported245074
07

Study locations

1 site
  • Jales Cancer Hospital
    Jales, São Paulo 15706-396, Brazil
08

References and documents

Publications

  • Zanon JR, Santos TM, Durante H, Hirai WY, Mimica MJ, Fregnani JHTG, Dos Reis R. Antibiotic prophylaxis in percutaneous nephrostomy placements and replacements for malignant urinary tract obstruction. Retrospective cohort study with systematic review and meta-analysis. Front Radiol. 2026 May 19;6:1787168. doi: 10.3389/fradi.2026.1787168. eCollection 2026. PubMed 42238679 ↗

Study documents

  • Study protocol · Jan 11, 2021
  • Statistical analysis plan · Jan 11, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Publication in a peer-reviewed journal and release of data upon plausible justification

Supporting information: Study protocol, Sap, Analytic code

09

Registry details

Key details

Study ID
NCT06801405
Lead sponsor
Barretos Cancer Hospital
Responsible party
Jeferson Rodrigo Zanon (Principal Investigator, Barretos Cancer Hospital) — Principal investigator
First posted
Jan 30, 2025
Start date
Apr 2, 2021
Primary completion
Oct 10, 2024
Completion
Oct 10, 2024
Results posted
May 19, 2026
Last update
May 19, 2026

Study contacts

Ricardo RD Reis
study chair · Barretos Cancer Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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