Should All Patients Receive Extended Oral Antibiotic Prophylaxis? Defining Its Role in Patients Undergoing Primary and Aseptic Revision Total Joint Arthroplasty.

Autor: Bundschuh KE; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Muffly BT; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Ayeni AM; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Heo KY; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Khawaja SR; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Tocio AJ; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Karzon AL; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Premkumar A; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia., Guild GN 3rd; Department of Orthopaedic Surgery, Investigation performed at Emory University, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2024 Sep; Vol. 39 (9S2), pp. S117-S121.e4. Date of Electronic Publication: 2024 Jan 11.
DOI: 10.1016/j.arth.2024.01.012
Abstrakt: Background: Prior studies have demonstrated reduced periprosthetic joint infection (PJI) rates following extended oral antibiotics (EOAs) for high-risk patients undergoing primary total joint arthroplasty (TJA). This study compared 3-month PJI rates in all patients undergoing primary or aseptic revision TJA with or without EOA prophylaxis.
Methods: In total, 2,982 consecutive primary (n = 2,677) and aseptic revision (n = 305) TJAs were performed by a single, fellowship-trained arthroplasty surgeon from 2016 to 2022 were retrospectively reviewed. Beginning January 2020, all patients received 7 days of 300 mg oral cefdinir twice daily immediately postoperatively. Rates of PJI at 3 months were compared between patients who received or did not receive EOA.
Results: Rates of PJI at 3 months in patients undergoing primary and aseptic revision TJA were significantly lower in those receiving EOA prophylaxis compared to those who did not (0.41 versus 1.13%, respectively; P = .02). After primary TJA, lower PJI rates were observed with EOA prophylaxis utilization (0.23 versus 0.74%, P = .04; odds ratio [OR] 3.85). Following aseptic revision TJA, PJI rates trended toward a significant decrease with the EOA compared to without (1.88 versus 4.83%, respectively; P = .16; OR 2.71).
Conclusions: All patients undergoing primary or aseptic revision TJA who received EOA prophylaxis were 3.85 and 2.71 times less likely, respectively, to develop PJI at 3 months compared to those without EOA. Future studies are needed to determine if these results are maintained at postoperative time periods beyond 3 months following primary TJA.
Level of Evidence: III, Retrospective review.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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