Hi, in our practise we routinely do Urine CS one week before PCNl if positive start antibiotics. If urgent need of surgery and patient is asymptomatic TLC is normal, even with urine CS positive we do PCNL with atheist few dose of preoperative antibiotics.

During surgery we do give antibiotics at the time of induction of surgery.

And at the time of stone breaking we guve one dose of amikacin along with lasix.

Post operative we do give antibiotics as required till discharge.

Of Pus during initial puncture we keep PC N for drainage and do surgery later

Thanx