Impact of Extended Prophylactic Antibiotics on Risk of Prosthetic Joint Infection in Primary Total Hip Arthroplasty: A Matched Cohort Analysis.
| Autor: | Kubsad S; From the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA., Collins AP, Dasari SP, Chansky HA, Fernando ND, Hernandez NM |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2024 Sep 10. Date of Electronic Publication: 2024 Sep 10. |
| DOI: | 10.5435/JAAOS-D-24-00290 |
| Abstrakt: | Background: Extended oral prophylactic antibiotics have been increasingly used in arthroplasty with the goal of reducing the risk of prosthetic joint infection (PJI). While a reduction in the rate of PJI has been noted with extended oral antibiotic regimens in high-risk patients, no large database study has assessed infection risk after primary total hip arthroplasty among well-balanced cohorts receiving and not receiving postoperative extended oral antibiotics. Methods: A retrospective cohort study was conducted using a national database, TriNetX, to identify patients who underwent primary total hip arthroplasty. This cohort was stratified by oral antibiotic prescription within one day of procedure. A one-to-one propensity score matching based on age, sex, class of obesity, and medical comorbidities was conducted. Outcomes explored in this study were 90-day risk of PJI, superficial skin infection, deep skin infection, and all-cause revision. Results: 90-day postoperative infection complications of PJI were higher in the group receiving antibiotics (hazard ratio: 1.83, P -value = 0.012). Other complications such as superficial skin infection, deep skin infection, and all-cause revision showed no statistically significant differences. Conclusion: This database analysis of 5,476 patients demonstrated no decrease in complications of PJI, superficial or deep skin infection, or revision at 90 days. Future randomized controlled trials are needed to evaluate the efficacy of extended oral antibiotics. Level of Evidence: III. (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.) |
| Databáze: | MEDLINE |
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