Prophylactic antibiotics in hip fractures. A double-blind, prospective study.

Burnett, J W; Gustilo, Ramon B.; Williams, David N.; Kind, A

doi:10.2106/00004623-198062030-00017

Cited by 110 publications

(27 citation statements)

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“…The intrinsic factors included the age, nutritional status, obesity, additional nosocomial infections, a long preoperative stay and corticosteroid therapy [17]. In our study, advanced age was responsible for the infections (although it was not shown to be an independent contributing factor), as was reported in other studies, as well [17,18]. The elderly patients often had several risk factors like hypertension, cardiac abnormalities, Diabetes mellitus and other immunosuppressive conditions.…”

Section: Discussionsupporting

confidence: 68%

“…In our study, the devices were removed in 50% of the cases, while the rest of the patients were treated with intravenous antibiotics and multiple wound debridement. A recent evidence from observational trials [12,13] and one randomized clinical trial [14] indicated that a subset of patients can be successfully treated by debridement and a long-term antimicrobial therapy with the retention of the implant. It has been stated that the patients who are eligible for such a treatment must meet the following criteria: an acute infection with its signs and symptoms lasting for <14-28 days, an unambiguous diagnosis which is based on the Three isolates which showed biofilm formation were isolated repeatedly in spite of an extensive antimicrobial therapy and the infection was resolved only following the implant removal.…”

Section: Resultsmentioning

confidence: 99%

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The Microbiological Profiles of Infected Prosthetic Implants with an Emphasis on the Organisms which Form Biofilms

Fernandes¹

2013

JCDR

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Background: In spite of the decreasing incidence of orthopaedic device related infections to 1%, nowadays, device-related infections still remain a diagnostic, therapeutic and cost -related problem. Aims and Objective:To record the common causative organisms and the contributing risk factors for orthopaedic device-related infections in a tertiary care teaching hospital. Methods:In a prospective study, fifty patients who underwent orthopaedic device implantation from Jan 2009 -June 2010 were enrolled; among them, 42 patients were complicated with infections. The demography, microbiological data, treatment and the outcome of each patient were recorded. Statistical Analysis:The data was analyzed in terms of frequency and percentage.Results: Of the 50 samples, 42(84%) were culture positive, while 8(16%) were cultures negative. The femur was the most commonly affected bone in both males (median age-37.1yrs) and females (median age-41.3 yrs). Staphylococcus aureus was the organism which was most commonly isolated and which caused biofilms, followed by non-fermenting, gram negative bacilli and Klebsiella spp. We reported the first case till date in the literature of Candida krusei PJI, to the best of our knowledge. No anaerobes were isolated. Tissue trauma, open fractures, post-operative surgical site infections and Diabetes mellitus were found to be the important risk factors. The biofilm forming organisms were commonly associated with polymicrobial infections and even an aggressive antibiotic therapy was often inadequate to eliminate the infections. A conservative surgical treatment was associated with treatment failures. Implant removal or replacement was required in most of the cases to eradicate the infection. Conclusion:The most common bacteria which were isolated included Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella. A majority of them are resistant to the commonly used antibiotics, leading to treatment failures which necessitated an implant removal. InTROduCTIOnA prosthetic replacement and an implant surgery is commonplace in orthopaedic operations for successfully alleviating the pain and improving the mobility in damaged joints.

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Section: Discussionsupporting

confidence: 68%

Section: Resultsmentioning

confidence: 99%

The Microbiological Profiles of Infected Prosthetic Implants with an Emphasis on the Organisms which Form Biofilms

Fernandes¹

2013

JCDR

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“…For several reasons, it is important to reduce the consumption of antibiotics, which may create a false sense of security, may promote growth of drug-resistant bacterial strains, can cause allergic and toxic side effects, may be instituted to make up for technical laxity and carelessness, and, finally, are expensive (Bowers et al 1973, Bumett et al 1980.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis in surgery for hip fractures

Hjortrup¹,

Sørensen²,

Mejdahl³

et al. 1990

Acta Orthopaedica Scandinavica

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“…Moreover, even in patients with SSI, nonvirulent bacteria were more prevalent than virulent bacteria (four cases of CNS vs. two cases of S. aureus). We were unable to precisely determine the source of drain tip contamination, but the most plausible hypothesis is that during the operation, microorganisms located outside of the body migrated into the patient's deep soft tissue [17].…”

Section: Discussionmentioning

confidence: 99%