Perioperative Antibiotics

Hansen, Erik N.; Belden, Katherine; Silibovsky, Randi; Vogt, Markus; Arnold, William V.; Bićanić, Goran; Bini, Stefano A.; Catani, Fabio; Chen, Jiying; Ghazavi, Mohammad; Godefroy, Karine M.; Holham, Paul; Hosseinzadeh, Hamid Reza Seyyed; Kim, Kang I.I.; Kirketerp‐Møller, Klaus; Lidgren, Lars; Lin, Jian Hao; Lonner, Jess H.; Moore, Christopher C.; Papagelopoulos, Panayiotis J.; Poultsides, Lazaros; Randall, R. Lor; Roslund, Brian; Saleh, Khaled J.; Salmon, Julia V.; Schwarz, Edward M.; Stuyck, Jos; Dahl, Annette W; Yamada, Koji

doi:10.1016/j.arth.2013.09.030

Cited by 57 publications

(51 citation statements)

References 198 publications

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“…In addition, skin testing can be a useful tool in distinguishing allergy and guiding antibiotic selection. Although skin testing penicillin-allergic patients cannot reliably predict an allergic response to cephalosporins with dissimilar side chains such as cefazolin, it can help identify whether a true allergy to penicillin exists in patients with a reported hypersensitivity, because a negative test result can reliably predict who can receive the antibiotic [3,9,14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Current guidelines recommend that a first-or second-generation cephalosporin (cefazolin or cefuroxime) be primarily used because commensal Gram-positive bacteria remain the most likely infecting organisms [1,4,9]. However, when patients have a penicillin or b-lactam allergy, first-and second-generation cephalosporins often are avoided because of fears of crossreactivity.…”

Section: Introductionmentioning

confidence: 99%

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Is Vancomycin-only Prophylaxis for Patients With Penicillin Allergy Associated With Increased Risk of Infection After Arthroplasty?

Tan

Springer

Ruder

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Preoperative antibiotic prophylaxis remains one of the most important strategies for prevention of postoperative infection. In patients with penicillin allergy, alternative medications such as vancomycin are often used despite reduced antimicrobial coverage and recent literature questioning the efficacy of vancomycin monotherapy. Questions/purposes (1) Are patients who receive vancomycin alone for penicillin allergy at greater odds of developing surgical site infection (SSI) as compared with patients who receive cefazolin for prophylaxis before total joint arthroplasty (TJA) without a patient-reported allergy? (2) What organism profile is associated with vancomycin monotherapy?Methods We performed a retrospective study of 10,391 primary TJAs performed between 2005 and 2014 at two institutions with a minimum of 1-year followup. Patients reporting penicillin or cephalosporin allergy were electronically queried from the anesthesia note. The odds of deep SSI and causative organisms were compared using multivariate analysis between b-lactam-allergic patients receiving vancomycin and nonallergic patients receiving cefazolin. Results After controlling for potential confounders, including comorbidities, we found that vancomycin alone did not affect the odds of deep SSI development (adjusted odds ratio [OR], 0.98; 95% confidence interval [CI], 0.67-1.43; p = 0.907). Although the overall odds of deep SSI were not different for patients receiving vancomycin versus cefazolin, we found that vancomycin was associated with a reduced risk of infection with Gram-positive organisms (adjusted OR, 0.25 [CI,; p = 0.003) and antibiotic-resistant organisms (adjusted OR, 0.10 [CI,

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Vancomycin-only Prophylaxis for Patients With Penicillin Allergy Associated With Increased Risk of Infection After Arthroplasty?

Tan

Springer

Ruder

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…The timing can be extended up to two hours for vancomycin and fluoroquinolones. No special considerations are required for patients with preexisting prostheses such as heart valves, and the same antibiotics can be used (45).…”

Section: The Icm Commentmentioning

confidence: 99%

Prevention of Periprosthetic Joint Infection

Rezapoor

Parvızı

2015

The Journal of Arthroplasty

116

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“…All patients preoperatively received antibacterial prophylaxis with fi rst-generation cephalosporins or clindamycin, which is in accordance with recent guidelines 7,8 . A thigh tourniquet was infl ated at 250-300 mm Hg before the beginning of surgery.…”

Section: Methodsmentioning

confidence: 99%

Influence of Fondaparinux Versus Nadroparin Calcium Thromboprophylaxis on Clinical Parameters Following Total Knee Arthroplasty

Mihaljević¹

2016

acc

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SUMMARY -Fondaparinux has been shown to be as eff ective as low molecular weight heparin in orthopedic surgery, with no cases of heparin induced thrombocytopenia proven until today. Th e main goal of this prospective randomized controlled trial was to defi ne whether thromboprophylaxis in patients with primary osteoarthritis of the knee undergoing total knee arthroplasty (TKA) infl uences clinical parameters in the same manner in patients receiving fondaparinux as in those receiving nadroparin during the fi rst 7 postoperative days. Sixty patients with primary knee osteoarthritis underwent unilateral TKA performed by the same surgeon and were randomized into two groups of 30 patients receiving either fondaparinux or nadroparin thromboprophylaxis. Patients were compared according to the duration of operation, perioperative blood loss, laboratory results and clinical evaluation of the edema during the early postoperative period. No diff erences were found between the groups in the mean duration of surgery, perioperative blood loss, and most of laboratory results. Th e level of urea was signifi cantly lower in the nadroparin group on the fi rst and second postoperative day. No cases of heparin induced thrombocytopenia, deep vein thrombosis or pulmonary embolism were noted during the study. Study results showed both fondaparinux and nadroparin to have the same infl uence on clinical parameters during the fi rst 7 postoperative days in patients undergoing TKA.

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Perioperative Antibiotics

Cited by 57 publications

References 198 publications

Is Vancomycin-only Prophylaxis for Patients With Penicillin Allergy Associated With Increased Risk of Infection After Arthroplasty?

Is Vancomycin-only Prophylaxis for Patients With Penicillin Allergy Associated With Increased Risk of Infection After Arthroplasty?

Prevention of Periprosthetic Joint Infection

Influence of Fondaparinux Versus Nadroparin Calcium Thromboprophylaxis on Clinical Parameters Following Total Knee Arthroplasty

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