JBJS | Prophylactic Antibiotics in Hip and Knee Arthroplasty

The Journal of Bone & Joint Surgery, Volume 91, Issue 10

Current Concepts Review | October 01, 2009

Prophylactic Antibiotics in Hip and Knee Arthroplasty

John Meehan, MD¹; Amir A. Jamali, MD¹; Hien Nguyen, MD²

¹ Department of Orthopaedic Surgery, University of California at Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817. E-mail address for J. Meehan: John.Meehan@ucdmc.ucdavis.edu. E-mail address for A.A. Jamali: Amir.Jamali@ucdmc.ucdavis.edu
² Division of Infectious Diseases, Department of Internal Medicine, University of California at Davis, 4150 V Street, Sacramento, CA 95817. E-mail address: Hien.Nguyen@ucdmc.ucdavis.edu

The Journal of Bone & Joint Surgery. 2009; 91:2480-2490 doi:10.2106/JBJS.H.01219

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Abstract

Prophylactic parenteral antibiotics have contributed to the present low rate of surgical site infections following hip and knee arthroplasty.

Over the past decade, there has been a change in the pattern of methicillin-resistant Staphylococcus aureus infections from hospital-acquired to community-acquired.

The findings of recent studies on screening programs to identify carriers of methicillin-resistant Staphylococcus aureus have been equivocal, with some studies showing that such programs reduce the rate of infections and others showing no effect on infection rates.

Hospitals with antibiogram data that reveal high Staphylococcus resistance should consider use of vancomycin as a prophylactic antibiotic.

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Topics

antibiotic prophylaxis ; hip region ; hip joint ; infection ; knee replacement arthroplasty ; surgical wound infection ; vancomycin ; antibiotics ; methicillin-resistant staphylococcus aureus

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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