*Purpose: Ureteral stents are commonly placed during kidney transplantation (KT). Urinary tract infections (UTI) are a common risk factor after KT and can have detrimental effects on graft outcomes. Current guidelines do not make recommendations regarding the use of antibiotic (AB) prophylaxis for stent removal (SR). We aimed to study AB prophylaxis practice at the time of SR, rate of UTI after removal and predictors of UTI.

*Methods: Single center retrospective review of adult (>18 years) KT recipients who underwent ureteral stent placement between 1/2018 and 9/2019, were included. Patients receiving simultaneous organ transplantation or being treated for UTI at time of SR are excluded. Baseline demographic, urinalysis and urine culture data before and 1 month after SR were analyzed. UTI was defined as a positive urine culture with >10⁵ CFU or documented sepsis with concordant urine and blood culture pathogens. Mann-Whitney (continuous variables) and Fisher’s exact (categorical variables) tests were used. Logistic regression for independent risk factors of UTI within 4 weeks of SR was done.

*Results: 78/265 (29%) patients received antibiotic at time of SR (+AB). These patients had more SR in the operating room during simultaneous peritoneal dialysis catheter removal (Table 1). All other perioperative variables between the +AB and -AB groups were similar. There was no difference in incidence of post-SR UTI in the both groups (P=0.21). Urine cultures prior to SR were sent more often in patients with longer duration of indwelling catheter (P=0.04, 9.2 days vs 7.2). Longer hospital stay (OR 1.24 [1.05-1.46], P=0.01) increased UTI rate (Table 2). UTI between KT and SR had an OR 4.72 ([0.99-22.4], P=0.05).

*Conclusions: Additional AB prophylaxis at the time of SR does not appear to reduce the incidence of UTI. Prophylaxis may be beneficial for recipients who had an interval UTI before the time of SR.

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