BMC urology
Efficacy of fosfomycin tromethamine powder in preventing biofilm-forming bacterial colonization on double-j stents in patients with upper urinary tract calculi
By Ye JB, Huang M, Cai X and 4 others.
Abstract
Objective
To evaluate the efficacy and safety of fosfomycin tromethamine powder (FMT) for preventing biofilm-forming bacterial colonization on double-J (DJ) stents in patients with upper urinary tract calculi.
Methods
From January 2024 to June 2025, we prospectively enrolled 200 adult patients with upper urinary tract calculi undergoing double-J stent placement after endoscopic laser lithotripsy at our tertiary medical center and randomly assigned them in a 1:1 ratio to the experimental or control group (n = 100 per group). Patients in the experimental group received a single oral dose of 3 g FMT one day before double-J stent placement and on postoperative days 7 and 15. Patients in the control group received intravenous cefuroxime (CXM), 1.5 g per dose, administered twice daily one day before stent placement and on postoperative days 1 and 2. Stent surface samples were collected at the time of DJ stent removal for quantitative bacterial biofilm culture, microbial species identification, and antimicrobial susceptibility testing. Baseline clinical characteristics, Double-J Stent Symptom Score (DJSS) (assessed during indwelling), SF-36 Health Survey quality-of-life score, numerical rating scale (NRS) pain score, and urine analysis parameters at stent removal were systematically recorded. All statistical analyses were conducted using SPSS version 26.0, with statistical significance defined as a two-sided p-value < 0.05.