Antibiotic prophylaxis in primary hip and knee arthroplasty: comparison between cefuroxime and two specific antistaphylococcal agents

J Arthroplasty. 2010 Oct;25(7):1078-82. doi: 10.1016/j.arth.2010.01.105. Epub 2010 Apr 8.

Abstract

This is a prospective randomized study comparing cefuroxime to 2 antistaphylococal agents (fusidic acid and vancomycin), for prophylaxis in total hip arthroplasty (THA) and total knee arthroplasty (TKA) in an institute, where methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) prevalence exceeds 25% of orthopedic infections. There were 3 patient groups. Group A included the patients who received cefuroxime, group B those who received fusidic acid, and group C those who received vancomycin. Patients were evaluated for the presence of superficial and/or deep infection at the surgical site. Statistical analysis did not reveal any substantial difference between the 3 groups. We do not recommend the use of specific antistaphylococcal agents for prophylactic use in primary THA and TKA, even in institution where MRSA and MRSE exceed 25% of orthopedic infections.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Cefuroxime / therapeutic use*
  • Fusidic Acid / therapeutic use*
  • Hip Prosthesis / microbiology
  • Humans
  • Incidence
  • Knee Prosthesis / microbiology
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Prospective Studies
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / prevention & control*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / prevention & control
  • Staphylococcus epidermidis / isolation & purification
  • Treatment Outcome
  • Vancomycin / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Fusidic Acid
  • Vancomycin
  • Cefuroxime