Dual-Agent Antibiotic Prophylaxis Using a Single Preoperative Vancomycin Dose Effectively Reduces Prosthetic Joint Infection Rates With Minimal Renal Toxicity Risk
| Autor: | Emily Leary, John R. Burger, James A. Keeney, Ajay Aggarwal, Benjamin J. Hansen |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections medicine.drug_class Vancomycin Dose Arthroplasty Replacement Hip Cephalosporin Cefazolin Kidney 03 medical and health sciences 0302 clinical medicine Vancomycin medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Antibiotic prophylaxis Arthroplasty Replacement Knee Aged Retrospective Studies 030222 orthopedics Arthritis Infectious business.industry Prosthetic joint infection Retrospective cohort study biochemical phenomena metabolism and nutrition Antibiotic Prophylaxis Middle Aged Surgery Anti-Bacterial Agents Toxicity Female business medicine.drug |
| Zdroj: | The Journal of arthroplasty. 33(7S) |
| ISSN: | 1532-8406 |
| Popis: | We performed this study to compare prosthetic joint infection (PJI) and renal toxicity rates following hip and knee total joint arthroplasty (TJA) when a first-generation cephalosporin was administered either alone or in combination with a single preoperative vancomycin dose, whether vancomycin administration timing potentially influenced dual-antibiotic PJI prophylaxis approach effectiveness, and whether single-dose vancomycin use increased risk of renal impairment.This was a retrospective study of 1997 consecutive primary TJAs (1871 patients) treated with cefazolin alone (1044 TJAs) or cefazolin with single-dose vancomycin (953 TJAs). The vancomycin group included 476 TJAs (450 patients) with infusion started at least 45 minutes before the skin incision and 477 TJAs (464 patients) with infusion started less than 45 minutes before the skin incision.The addition of a single dose of vancomycin did not significantly reduce PJI rates when compared with cefazolin alone (1.6% vs 2.1%, P = .32). However, the PJI rate was significantly lower following primary TJA when vancomycin administration was initiated at least 45 minutes before incision (0.2%) when compared with other TJA procedures performed using cefazolin and vancomycin (2.9%, P.01) or cefazolin alone (2.1%, P.01). We observed no difference in renal toxicity between treatment groups.In our institution, the addition of vancomycin to cefazolin at least 45 minutes before incision reduced PJI infection rates in primary hip and knee TJA with a low risk of renal impairment. |
| Databáze: | OpenAIRE |
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