Prophylaxis with Teicoplanin and Cefuroxime Reduces the Rate of Prosthetic Joint Infection after Primary Arthroplasty
| العنوان: | Prophylaxis with Teicoplanin and Cefuroxime Reduces the Rate of Prosthetic Joint Infection after Primary Arthroplasty |
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| المؤلفون: | Laura Morata, Marta Sala, Guillem Bori, Sebastián García-Ramiro, Alex Soriano, Eduard Tornero, Josep Mensa, J.C. Martínez-Pastor, Misericordia Basora, Jordi Bosch |
| المصدر: | Antimicrobial Agents and Chemotherapy. 59:831-837 |
| بيانات النشر: | American Society for Microbiology, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Prosthesis-Related Infections, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Clinical Therapeutics, Lower risk, medicine, Humans, Pharmacology (medical), Arthroplasty, Replacement, Knee, Aged, Retrospective Studies, Pharmacology, Cefuroxime, Teicoplanin, Proportional hazards model, business.industry, Hazard ratio, Retrospective cohort study, Middle Aged, Arthroplasty, Confidence interval, Anti-Bacterial Agents, Surgery, Infectious Diseases, Female, business, medicine.drug |
| الوصف: | The aim of this study was to compare the prosthetic joint infection (PJI) rate after total joint arthroplasty in two consecutive periods of treatment with different antibiotic prophylaxes: cefuroxime versus cefuroxime plus teicoplanin. We retrospectively reviewed 1,896 patients who underwent total hip arthroplasty or total knee arthroplasty between March 2010 and February 2013. From March 2010 to August 2011, patients received 1.5 g of cefuroxime during induction of anesthesia and another 1.5 g 2 h later (the C group). From September 2011, 800 mg of teicoplanin was added to cefuroxime (the CT group). Throughout the period studied, there were no variations in pre- or postoperative protocols. Univariate and multivariate analyses were performed to evaluate independent predictors of PJI. There were 995 (55.7%) patients in the C group and 791 (44.3%) in the CT group. Patients in the CT group had a significantly lower PJI rate than patients in the C group (1.26% versus 3.51%, P = 0.002). There were no infections due to Staphylococcus aureus in the CT group (0% versus 1.6% in the C group, P < 0.001). A stepwise forward Cox regression model identified male sex (hazard ratio [HR], 3.85; 95% confidence interval [CI], 2.09 to 7.18), a body mass index of ≥35 kg/m 2 (HR, 2.93; 95% CI, 1.37 to 6.27), the presence of lung disease (HR, 2.46; 95% CI, 1.17 to 5.15), and red blood cell transfusion (HR, 3.70; 95% CI, 1.89 to 7.23) to be independent variables associated with a higher risk of PJI. The addition of teicoplanin was associated with a lower risk of infection (HR, 0.35; 95% CI, 0.17 to 0.74). In conclusion, the addition of teicoplanin to cefuroxime during primary arthroplasty was associated with a significant reduction in the global PJI rate due to a reduction of infections caused by Gram-positive bacteria. |
| تدمد: | 1098-6596 0066-4804 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6c5004273f24201cab1bfb705eb03ac3 https://doi.org/10.1128/aac.03949-14 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....6c5004273f24201cab1bfb705eb03ac3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10986596 00664804 |
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