ArticleAnnals of the Royal College of Surgeons of England2013
Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011.
Article in Annals of the Royal College of Surgeons of England, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- Dicloxacillin induces CYP2C19, CYP2C9 and CYP3A4 in vivo and in vitro.British journal of clinical pharmacology · 2018Trial
- Article
- Antimicrobial prophylaxis with teicoplanin plus gentamicin in primary total joint arthroplasty.Journal of bone and joint infection · 2023Article
- Value of antibiotic prophylaxis in routine knee arthroscopy : A retrospective study.Der Orthopade · 2018Article
- Biofilm and the Role of Antibiotics in the Treatment of Periprosthetic Hip and Knee Joint Infections.The open orthopaedics journal · 2016Article
- Prophylactic antibiotics in total joint arthroplasty: evolution or devolution?Bone & joint research · 2015Article
- Prophylactic antibiotics in elective hip and knee arthroplasty: an analysis of organisms reported to cause infections and National survey of clinical practice.Bone & joint research · 2015Article
- Prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies.International journal of clinical and experimental medicine · 2015Article
- A comparative study of 5 different antibiotic prophylaxis regimes in 4500 total knee replacements.Journal of clinical orthopaedics and traumaArticle
- Additional doses of prophylactic antibiotics post-arthroplasty: Are there any benefits?Journal of perioperative practiceReview
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAntimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. The aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011.
methodsTwo questionnaires (one in 2008 and one in 2011) were sent to all National Health Service trusts in the UK using the Freedom of Information Act.
resultsIn total, 87% of trusts that perform orthopaedic surgery responded. The use of cefuroxime more than halved between 2005 and 2011 from 80% to 36% and 78% to 26% in elective surgery and trauma surgery respectively. Combination therapy with flucloxacillin and gentamicin rose from 1% to 32% in elective and 1% to 34% in trauma surgery. Other increasingly popular regimes include teicoplanin and gentamicin (1% to 10% in elective, 1% to 6% in trauma) and co-amoxiclav (3% to 8% in elective, 4% to 14% in trauma). The majority of changes occurred between 2008 and 2010. Over half (56%) of the trusts stated that Clostridium difficile was the main reason for changing regimes.
conclusionsIn 2008 a systematic review involving 11,343 participants failed to show a difference in surgical site infections when comparing different antimicrobial prophylaxis regimes in orthopaedic surgery. Concerns over C difficile and methicillin resistant Staphylococcus aureus have influenced antimicrobial regimes in both trauma and elective surgery. Teicoplanin would be an appropriate choice for antimicrobial prophylaxis in both trauma and elective units but this is not reflected in its current level of popularity.
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