Role of prophylactic antibiotics in lesser toe fusion surgery: A prospective randomised controlled trial.
BACKGROUND
This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery.


METHODS
100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n=48) and those who did not (Group 2, n=52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection.


RESULTS
The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients.


CONCLUSIONS
The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.
Consultant in Trauma and Orthopaedics, University Hospitals of Leicester, NHS Trust, UK. Electronic address: jmangwani@hotmail.com.
J
J
Mangwani
Specialist Registrar in Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, UK. Electronic address: gulatiaashish@doctors.org.uk.
A
A
Gulati
Consultant in Trauma and Orthopaedic Surgery, Maidstone and Tunbridge Wells NHS Trust, UK.
R
R
Benson
Consultant Podiatrist-Podiatric Surgeon, Great Western Hospital, Swindon and Marlborough NHS Trust, UK.
M
M
Cichero
Consultant in Trauma and Orthopaedics, Great Western Hospital, Swindon and Marlborough NHS Trust, UK.
D M
DM
Williamson
D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001174:Arthrodesis / Q000009:adverse effects*; D001864:Bone Wires; D005260:Female; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D014033:Toe Joint
Antibiotics; Infection; K-wires