Optimal Timing and Antibiotic Prophylaxis in Periprosthetic Joint Infection (PJI): Literature Review and World Consensus (Part Three)

Parvızı, Javad; Ghazavi, Mohammad; Meeting, Members of Pre-Op Antibiotics Committee of the Consensus

doi:10.17795/soj-2355

Cited by 2 publications

(1 citation statement)

References 63 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In light of this, various expanded combination SAP regimens have been proposed and analyzed in small clinical studies, with different effects but no conclusive results because of their methodological limitations [ 12 , 13 , 14 , 15 , 16 , 17 ]. Consequently, routine prophylactic use of dual antibiotics (such as cephalosporins and aminoglycosides or cephalosporins and vancomycin) is not currently recommended [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Bacterial Contamination and Activity of Different Antimicrobial Prophylaxis Regimens in Primary Knee and Hip Replacement

et al. 2020

View full text Add to dashboard Cite

Surgical antimicrobial prophylaxis (SAP) is important for the prevention of prosthetic joint infections (PJIs) and must be effective against the microorganisms most likely to contaminate the surgical site. Our aim was to compare different SAP regimens (cefazolin, cefuroxime, or vancomycin, alone or combined with gentamicin) in patients undergoing total knee (TKA) and hip (THA) arthroplasty. In this preclinical exploratory analysis, we analyzed the results of intraoperative sample cultures, the ratio of plasma antibiotic levels to the minimum inhibitory concentrations (MICs) for bacteria isolated at the surgical wound and ATCC strains, and serum bactericidal titers (SBT) against the same microorganisms. A total of 132 surgical procedures (68 TKA, 64 THA) in 128 patients were included. Cultures were positive in 57 (43.2%) procedures (mostly for coagulase-negative staphylococci and Cutibacterium spp.); the rate was lower in the group of patients receiving combination SAP (adjusted OR 0.475, CI95% 0.229–0.987). The SAP regimens evaluated achieved plasma levels above the MICs in almost all of intraoperative isolates (93/94, 98.9%) and showed bactericidal activity against all of them (SBT range 1:8–1:1024), although SBTs were higher in patients receiving cefazolin and gentamicin-containing regimens. The potential clinical relevance of these findings in the prevention of PJIs remains to be determined.

show abstract