Document Detail


Prophylactic oral antibiotics reduce reinfection rates following two-stage revision total knee arthroplasty.
MedLine Citation:
PMID:  20213514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to compare the incidence of reinfection in patients who received oral antibiotic prophylaxis with those who did not following two-stage revision knee arthroplasty. Additional purposes included: (1) comparison of these findings to the infection rate in patients who underwent revision for aseptic reasons, and (2) characterisation of the organisms responsible for reinfection following revision procedures. Twenty-eight two-stage revision knee arthroplasty procedures were followed up by a mean of 33 days of oral antibiotics (range, 28-43 days), while the remaining 38 procedures received only 24-72 hours of in-patient antibiotics. The incidence of reinfection in each group within 12 months was compared. The reinfection rates were additionally compared to those of 237 patients who underwent revision for aseptic loosening over the same time period. Patients who were treated with postoperative antibiotic prophylaxis had a considerably lower reinfection rate, with one reinfection in the prophylaxis group (4%), compared to six reinfections in the no-prophylaxis group (16%). The reinfection rates remained higher compared to those found in patients who underwent revision knee arthroplasty for aseptic loosening (1 of 237 patients; 0.4%). Both high and low virulence organisms were identified in the patients who were subsequently reinfected. A minimum of 28 days of postoperative oral antibiotics appeared to decrease reinfection rates following two-stage revision knee arthroplasty. These results suggest that the use of oral antibiotic prophylaxis following re-implantation may be appropriate in all patients undergoing two-stage revision, even in the absence of any signs of active infection.
Authors:
Michael G Zywiel; Aaron J Johnson; D Alex Stroh; Jabari Martin; David R Marker; Michael A Mont
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-07
Journal Detail:
Title:  International orthopaedics     Volume:  35     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-04     Completed Date:  2011-04-14     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  37-42     Citation Subset:  IM    
Affiliation:
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
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MeSH Terms
Descriptor/Qualifier:
Acetamides / administration & dosage,  therapeutic use
Administration, Oral
Anti-Bacterial Agents / administration & dosage,  therapeutic use*
Antibiotic Prophylaxis*
Arthroplasty, Replacement, Knee / instrumentation*,  methods
Ciprofloxacin / administration & dosage,  therapeutic use
Dose-Response Relationship, Drug
Follow-Up Studies
Humans
Knee Prosthesis / microbiology*
Oxazolidinones / administration & dosage,  therapeutic use
Prevalence
Prospective Studies
Prosthesis-Related Infections / epidemiology,  prevention & control*
Reoperation / instrumentation,  methods
Retrospective Studies
Staphylococcal Infections / epidemiology,  prevention & control
Staphylococcus / isolation & purification
Trimethoprim-Sulfamethoxazole Combination / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Acetamides; 0/Anti-Bacterial Agents; 0/Oxazolidinones; 165800-03-3/linezolid; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination; 85721-33-1/Ciprofloxacin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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