Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up
Summary: Background: Cephalosporins are recommended as first-line antibiotic prophylaxis in total joint replacement surgery. Studies have shown an increased risk for periprosthetic joint infection (PJI) when non-cephalosporin antibiotics have been used. This study examines the effect of non-cephalo...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Infection Prevention in Practice |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590088923000185 |
| _version_ | 1797818289905205248 |
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| author | Meeri Honkanen Simo Sirkeoja Matti Karppelin Antti Eskelinen Jaana Syrjänen |
| author_facet | Meeri Honkanen Simo Sirkeoja Matti Karppelin Antti Eskelinen Jaana Syrjänen |
| author_sort | Meeri Honkanen |
| collection | DOAJ |
| description | Summary: Background: Cephalosporins are recommended as first-line antibiotic prophylaxis in total joint replacement surgery. Studies have shown an increased risk for periprosthetic joint infection (PJI) when non-cephalosporin antibiotics have been used. This study examines the effect of non-cephalosporin antibiotic prophylaxis on the risk for PJI. Methods: Patients with a primary hip or knee replacement performed from 2012 to 2020 were identified (27 220 joint replacements). The primary outcome was the occurrence of a PJI in a one-year follow-up. The association between perioperative antibiotic prophylaxis and the outcome was examined using logistic regression analysis. Discussion: Cefuroxime was used as prophylaxis in 26,467 operations (97.2%), clindamycin in 654 (2.4%) and vancomycin in 72 (0.3%). The incidence of PJI was 0.86% (228/26,467) with cefuroxime and 0.80% (6/753) with other prophylactic antibiotics. There was no difference in the risk for PJI with different prophylactic antibiotics in the univariate (OR 1.06, 95% CI 0.47–2.39) or multivariable analysis (OR 1.02, 95% CI 0.45–2.30). Conclusion: Non-cephalosporin antibiotic prophylaxis in primary total joint replacement surgery was not associated with an increased risk for PJI. |
| first_indexed | 2024-03-13T09:06:56Z |
| format | Article |
| id | doaj.art-7e5c96dbe18b4044a04f2a63f8a92dee |
| institution | Directory Open Access Journal |
| issn | 2590-0889 |
| language | English |
| last_indexed | 2024-03-13T09:06:56Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Infection Prevention in Practice |
| spelling | doaj.art-7e5c96dbe18b4044a04f2a63f8a92dee2023-05-28T04:09:10ZengElsevierInfection Prevention in Practice2590-08892023-06-0152100285Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-upMeeri Honkanen0Simo Sirkeoja1Matti Karppelin2Antti Eskelinen3Jaana Syrjänen4Department of Internal Medicine, Tampere University Hospital and Faculty of Medicine and Life Sciences, Tampere University, Finland; Corresponding author. Department of Internal Medicine, Tampere University Hospital, PL 2000, 33521 Tampere, Finland. Tel.: +358 3 311 69172.Department of Internal Medicine, Tampere University Hospital and Faculty of Medicine and Life Sciences, Tampere University, FinlandDepartment of Internal Medicine, Tampere University Hospital and Faculty of Medicine and Life Sciences, Tampere University, FinlandCoxa, Hospital for Joint Replacement, Tampere and Faculty of Medicine and Life Sciences, Tampere University, FinlandDepartment of Internal Medicine, Tampere University Hospital and Faculty of Medicine and Life Sciences, Tampere University, FinlandSummary: Background: Cephalosporins are recommended as first-line antibiotic prophylaxis in total joint replacement surgery. Studies have shown an increased risk for periprosthetic joint infection (PJI) when non-cephalosporin antibiotics have been used. This study examines the effect of non-cephalosporin antibiotic prophylaxis on the risk for PJI. Methods: Patients with a primary hip or knee replacement performed from 2012 to 2020 were identified (27 220 joint replacements). The primary outcome was the occurrence of a PJI in a one-year follow-up. The association between perioperative antibiotic prophylaxis and the outcome was examined using logistic regression analysis. Discussion: Cefuroxime was used as prophylaxis in 26,467 operations (97.2%), clindamycin in 654 (2.4%) and vancomycin in 72 (0.3%). The incidence of PJI was 0.86% (228/26,467) with cefuroxime and 0.80% (6/753) with other prophylactic antibiotics. There was no difference in the risk for PJI with different prophylactic antibiotics in the univariate (OR 1.06, 95% CI 0.47–2.39) or multivariable analysis (OR 1.02, 95% CI 0.45–2.30). Conclusion: Non-cephalosporin antibiotic prophylaxis in primary total joint replacement surgery was not associated with an increased risk for PJI.http://www.sciencedirect.com/science/article/pii/S2590088923000185Prosthetic joint infectionAntibiotic prophylaxisCephalosporins |
| spellingShingle | Meeri Honkanen Simo Sirkeoja Matti Karppelin Antti Eskelinen Jaana Syrjänen Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up Infection Prevention in Practice Prosthetic joint infection Antibiotic prophylaxis Cephalosporins |
| title | Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up |
| title_full | Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up |
| title_fullStr | Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up |
| title_full_unstemmed | Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up |
| title_short | Effect of non-cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery: a retrospective study with a 1-year follow-up |
| title_sort | effect of non cephalosporin antibiotic prophylaxis on the risk of periprosthetic joint infection after total joint replacement surgery a retrospective study with a 1 year follow up |
| topic | Prosthetic joint infection Antibiotic prophylaxis Cephalosporins |
| url | http://www.sciencedirect.com/science/article/pii/S2590088923000185 |
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