Integrative Use of Ningmitai Capsule and Cefoxitin in Treating Post-Ureteroscopic Lithotripsy Stent-Related Urinary Tract Infections.

Ureteral stent placement following ureteroscopic lithotripsy (URL) reduces obstruction but increases the risk of urinary tract infection (UTI). Conventional antibiotic therapy alone is often insufficient. Ningmitai capsule, a traditional Chinese herbal preparation, has demonstrated anti-inflammatory and antibacterial activity. This study evaluated the efficacy, safety, and translational value of combining Ningmitai with cefoxitin. A retrospective controlled study included 76 patients who developed UTI after URL with stent placement between May 2023 and October 2024. Patients were stratification-matched to a cefoxitin-only group (n = 38, cefoxitin only) or a combined group (n = 38, cefoxitin plus Ningmitai). Clinical efficacy, urinary symptom scores, inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), procalcitonin (PCT)], and adverse reactions were compared. Logistic regression identified independent predictors, and decision curve analysis (DCA) assessed clinical net benefit. The combined group achieved a higher efficacy rate than the cefoxitin-only group (94.74% vs. 78.95%, p = 0.042). Dysuria, urinary frequency, hematuria, and renal colic improved more significantly, and hs-CRP, IL-1β, and PCT levels decreased to a greater extent in the combined group (all p < 0.001). Combination therapy was an independent predictor of success (OR = 4.52, 95% CI: 1.56-13.06). The predictive model improved AUC from 0.71 to 0.91. DCA showed superior net benefit between 0.1-0.5 thresholds. Adverse events were rare and comparable between groups. Ningmitai capsule combined with cefoxitin improves symptoms, reduces inflammation, and maintains safety in stent-associated UTI after URL. Predictive modeling and DCA confirm its translational potential as an integrative therapeutic approach.