title: Antibiotic prophylaxis for hip fracture surgery: three-dose cefuroxime versus single-dose gentamicin and amoxicillin.
abstract: OBJECTIVE
  To compare a 3-dose cefuroxime regimen with a single-dose gentamicin and amoxicillin regimen as antibiotic prophylaxis for hip hemiarthroplasty in terms of microbiological outcome.
  
  
  METHODS
  Records of 2 matched groups of patients who underwent hip hemiarthroplasty for femoral neck fractures were reviewed. 29 men and 84 women (mean age, 82 years) who received a 3-dose cefuroxime regimen in 2006 were compared with 23 men and 84 women (mean age, 83 years) who received a single-dose gentamicin and amoxicillin regimen in 2008. Patient demographics, antibiotics prescribed in the peri- and immediate postoperative period, microbiological evidence for Clostridium difficile 'infection', length of hospital stay, mortality, as well as biochemical and haematological findings were reviewed.
  
  
  RESULTS
  The 3-dose cefuroxime group was significantly higher in terms of the mean length of hospital stay (17 vs. 13 days, p=0.043) and the percentage of patients receiving postoperative antibiotics (88% vs. 68%, p<0.001) and having C difficile 'infection' (6% vs. 0%, p=0.016). If patients with C difficile 'infection' were excluded, there was no significant difference in the length of hospital stay.
  
  
  CONCLUSIONS
  The single-dose gentamicin and amoxicillin regimen was associated with a lower C difficile 'infection' rate.
authors.affiliation: Department of Trauma and Orthopaedics, Sunderland Royal Hospital, Sunderland, United Kingdom.
authors.forename: Prithee
authors.initials: P
authors.lastname: Jettoo
authors.forename: Richard
authors.initials: R
authors.lastname: Jeavons
authors.forename: Bobby
authors.initials: B
authors.lastname: Siddiqui
authors.forename: Shaun
authors.initials: S
authors.lastname: O'Brien
mesh_terms: D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002444:Cefuroxime / Q000008:administration & dosage*; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000382:microbiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D005839:Gentamicins / Q000008:administration & dosage*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000658:Amoxicillin; D002444:Cefuroxime
keywords: Clostidium difficile; antibiotic prophylaxis; diarrhea; hip fractures