Antibiotic prophylaxis in primary hip and knee arthroplasty: comparison between cefuroxime and two specific antistaphylococcal agents.
This is a prospective randomized study comparing cefuroxime to 2 antistaphylococal agents (fusidic acid and vancomycin), for prophylaxis in total hip arthroplasty (THA) and total knee arthroplasty (TKA) in an institute, where methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) prevalence exceeds 25% of orthopedic infections. There were 3 patient groups. Group A included the patients who received cefuroxime, group B those who received fusidic acid, and group C those who received vancomycin. Patients were evaluated for the presence of superficial and/or deep infection at the surgical site. Statistical analysis did not reveal any substantial difference between the 3 groups. We do not recommend the use of specific antistaphylococcal agents for prophylactic use in primary THA and TKA, even in institution where MRSA and MRSE exceed 25% of orthopedic infections.
Tyllianakis
Minos E
ME
Orthopedic Department Patras University Hospital, Rio-Patras, Hellas, Greece.
Karageorgos
Athanasios Ch
ACh
Marangos
Markos N
MN
Saridis
Alkis G
AG
Lambiris
Elias E
EE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002444:Cefuroxime / Q000627:therapeutic use*; D005672:Fusidic Acid / Q000627:therapeutic use*; D006622:Hip Prosthesis / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis / Q000382:microbiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D014640:Vancomycin; D002444:Cefuroxime