How to optimize antibiotic prophylaxis in percutaneous kidney stone surgery?

Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large renal calculi (1). Post-PCNL urosepsis is a rare (0.3% to 5%) but life threatening complication and the most common cause of death in patients undergoing PCNL (2,3). Antibiotics according to previous microbiology results are usually administered pre- and/or intraoperatively in order to prevent infectious complications.