Antimicrobial prophylaxis for arthroplasty and total joint replacement: discussion and review of published clinical trials.

Cephalosporins are often administered to prevent infections that can follow total joint replacements (TJR) and other arthroplastic procedures. However, recommendations contained within published guidelines and review articles vary greatly from those given by the manufacturer in product information circulars. Similarly, the results of published clinical trials vary substantially with regard to the choice of cephalosporin, the dose and dosing interval, and the duration of administration that should be used for antimicrobial prophylaxis in patients undergoing clean orthopedic procedures. Well-designed clinical trials provide data concerning the appropriate use of cephalosporins for preventing infections that may follow TJR or joint arthroplasty.