Is a Single Dose of Antibiotic Prophylaxis Sufficient To Prevent Infections in Total Joint Arthroplasty

Abstract

Introduction: Prosthetic infection is a serious complication that can develop after knee and hip arthroplasty and remains a common reason for revision surgery. Guidelines recommend various measures to prevent infection, howewer some professional associat ions argue that there is insufficient evidence for single-dose antibiotic prophylaxis. Our study compares the outcomes of patients receiving short-and long-term antibiotic prophylaxis in arthroplasty surgery. Materials and Methods: In this retrospective study of 424 patients undergoing knee or hip arthroplasty, two prophylaxis protocols were compared. Group 1 (190 patients, 44.8%) received cefazolin pre-and postoperatively on day 1, while group 2 (234 patients, 55.2%) received extended cefazolin (5 days postoperatively) and oral amoxicillin clavulanic acid (5 days). Early postoperative infection rates wer e evaluated. Results: In this study, 83.4% of 424 patients who underwent total knee and hip arthroplasty were female. Knee and hip operations were performed in 86.8% and 13.2% of the patients, respectively. The mean age did not show a statistically significant difference. There was no significant difference between the groups in terms of periprosthetic infection rates (p=0.828). Posto perative wound complications were seen in 34 (18%) patients in group 1 and 44 (19%) patients in group 2, but this difference was not statistically significant (p=0.704). No significant difference in wound complications and prosthesis infection rates was fo und between group 1 and group 2 patients with risk factors (p>0.05). Conclusion: In primary joint arthroplasty, extended oral antibiotic prophylaxis did not provide additional protection against single-day antibiotic prophylaxis. The results were similar in both risk and non-risk groups. Considering antibiotic resistance, side effects and costs, it is concluded that extended prophylaxis is unnecessary. However, further large-scale studies on this subject are required. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.