Daniel Pérez-Prieto1, María E Portillo2, Lluís Puig-Verdié3, Albert Alier3, Carlo Gamba3, Pau Guirro3, Santos Martínez-Díaz3, Juan P Horcajada4, Andrej Trampuz5, Joan C Monllau3. 1. Orthopedic Department, Hospital del Mar - Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: dperezprieto@parcdesalutmar.cat. 2. Clinical Microbiology, Complejo Hospitalario de Navarra, Pamplona, Spain. 3. Orthopedic Department, Hospital del Mar - Universitat Autònoma de Barcelona, Barcelona, Spain. 4. Infectious Diseases Department, Hospital del Mar-IMIM, Universitat Pompeu Fabra, Barcelona, Spain. 5. Center for Septic Surgery, Charité - University Medicine, Berlin, Germany.
Abstract
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital. Patients were prospectively randomized into two groups. The control group received the classical preoperative antibiotic prophylaxis. The study group did not receive prophylaxis prior to surgery. RESULTS: There were 14 patients in each group. They correspond to 13 total hip arthroplasty infections, 12 total knee arthroplasty infections and 3 reverse shoulder prosthesis infections. There were 10 patients in the study group and 10 patients in the control group with at least one positive microbiological criterion (P > 0.05). There were 4 patients in each group with a culture negative PJI (P > 0.05). CONCLUSIONS:Preoperative antibiotic prophylaxis does not affect intraoperative cultures in suspected or confirmed PJI. Therefore it is essential to deliver antibiotic prophylaxis in any patient in which a prosthesis is to be implanted in order to protect the prosthesis from infection.
RCT Entities:
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital. Patients were prospectively randomized into two groups. The control group received the classical preoperative antibiotic prophylaxis. The study group did not receive prophylaxis prior to surgery. RESULTS: There were 14 patients in each group. They correspond to 13 total hip arthroplasty infections, 12 total knee arthroplasty infections and 3 reverse shoulder prosthesis infections. There were 10 patients in the study group and 10 patients in the control group with at least one positive microbiological criterion (P > 0.05). There were 4 patients in each group with a culture negative PJI (P > 0.05). CONCLUSIONS: Preoperative antibiotic prophylaxis does not affect intraoperative cultures in suspected or confirmed PJI. Therefore it is essential to deliver antibiotic prophylaxis in any patient in which a prosthesis is to be implanted in order to protect the prosthesis from infection.
Authors: Alexia Anagnostopoulos; Daniel A Bossard; Bruno Ledergerber; Patrick O Zingg; Annelies S Zinkernagel; Christian Gerber; Yvonne Achermann Journal: J Clin Microbiol Date: 2018-01-24 Impact factor: 5.948
Authors: Daniel Pérez-Prieto; María E Portillo; Lluís Puig-Verdié; Albert Alier; Santos Martínez; Lluisa Sorlí; Juan P Horcajada; Joan C Monllau Journal: Int Orthop Date: 2017-03-21 Impact factor: 3.075
Authors: Geertje A M Govaert; Richard Kuehl; Bridget L Atkins; Andrej Trampuz; Mario Morgenstern; William T Obremskey; Michael H J Verhofstad; Martin A McNally; Willem-Jan Metsemakers Journal: J Orthop Trauma Date: 2020-01 Impact factor: 2.884
Authors: Daniel Pérez-Prieto; Pedro Hinarejos; Albert Alier; Lluïsa Sorlí; Santos Martínez; Lluís Puig; Juan C Monllau Journal: BMC Musculoskelet Disord Date: 2021-08-02 Impact factor: 2.362