The cost-effectiveness of vancomycin for preventing infections following shoulder arthroplasty: a break even analysis

Hatch, Mark; Daniels, Stephen D.; Glerum, Kimberly M.; Higgins, Laurence D.

doi:10.1016/j.jse.2016.12.005

Cited by 1 publication

(3 citation statements)

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“…This consisted of four systematic reviews, 9-12 44 retrospective case series, 23 retrospective cohort studies, 12 diagnostic studies, [80][81][82][83][84][85][86][87][88][89][90][91] two in-vitro studies, 92,93 two epidemiological studies 5,94 and one economic decision analysis. 95 The characteristics of included studies are shown in Supplementary Table 1 and excluded studies including reasons for exclusion are in Supplementary Table 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Our search identified nine studies that reported on techniques for prophylaxis against PSI. This included four retrospective case series, 25,36,38,40 four retrospective cohort studies [66][67][68]70 and one economic decision analysis 95 (see Supplementary Table 6).…”

Section: Prophylaxis Against Psimentioning

confidence: 99%

“…67 Hatch et al calculated that if vancomycin powder placed into the operative wound resulted in a 0.01% to 0.19% absolute risk reduction for PSI then it would be cost effective (depending on the purchase prices of vancomycin at different centres). 95 Our search has not identified any studies demonstrating the effectiveness of vancomycin power in shoulder arthroplasty.…”

Section: Prophylaxis Against Psimentioning

confidence: 99%

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Scoping review: Diagnosis and management of periprosthetic joint infection in shoulder arthroplasty

et al. 2018

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Background: The aim of this scoping review is to assess the current evidence regarding periprosthetic shoulder infection to inform development of evidence and consensus-based guidelines. Methods: A search of Medline, Embase and PubMed was performed; two authors screened the results independently for inclusion. Results: Totally 88 studies were included. Incidence of periprosthetic shoulder infection ranged from 0.7% to 7%. The most common organisms to cause periprosthetic shoulder infection were Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and coagulase-negative Staphylococcus. Male gender and younger age are the most reported risk factors. Erythrocyte sedimentation rate, C-reactive protein and serum/synovial biomarkers had limited diagnostic accuracy. Thirty-nine studies reported the outcome of surgical management of periprosthetic shoulder infection. Eradication rates vary from 54% to 100% for debridement procedures; 66-100% for permanent spacers; 50-100% following single-stage revision; 60-100% following two-stage revision; and 66-100% following resection arthroplasty. Conclusion: There is wide heterogeneity in study designs and outcomes of studies are often contradictory and due to issues with methodology and small sample sizes the optimal pathways for diagnosis and management cannot be determined from this review. Future research should be based on larger cohorts and randomised trials where feasible to provide more valid research for guiding future treatment of periprosthetic shoulder infection.

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