Tikkinen KAO. et al., 2026: A Multicenter Randomized Controlled Trial of Antimicrobial Prophylaxis to Prevent Urinary Tract Infections After Shockwave Lithotripsy for Urolithiasis: The APPEAL Trial.

Tikkinen KAO, Tondroanamag F, Parpia S, Guyatt GH, Violette PD; APPEAL Trial Investigators. Reply to Vallée M, Stangl FP, Wagenlehner F et al's Letter to the Editor re: Tikkinen KAO, Najafabadi BT, Hajebrahimi S.
The APPEAL Trial. Eur Urol 2025;88(6):543-51. Eur Urol. 2026 Jun 25:S0302-2838(26)02229-3. doi: 10.1016/j.eururo.2026.06.008. Epub ahead of print.

Abstract

no Abstract available

Comment Peter Alken

This rebuttal to the comment of Vallée at al concludes somehow that we should do it right with or without the APPEAL trial: “The trial neither justifies routine prophylaxis, nor does it justify indiscriminate fluoroquinolone use. What it does justify is judicious consideration of prophylaxis in the context of patient risk, patient preferences, and antimicrobial stewardship.” So what is new?

See also Vallée M, Stangl FP, Wagenlehner F, Tandogdu Z, Kranz J, Bonkat G. Re: Tikkinen KAO, Najafabadi BT, Hajebrahimi S, et al. A Multicenter Randomized Controlled Trial of Antimicrobial Prophylaxis to Prevent Urinary Tract Infections after Shockwave Lithotripsy for Urolithiasis: The APPEAL Trial. Eur Urol 2025;88(6):543-51. Eur Urol. 2026 May 20:S0302-2838(26)02162-7. doi: 10.1016/j.eururo.2026.03.038. Epub ahead of print. PMID: 42161694.

Peter Alken