SynthesisInternational orthopaedics2018
Current evidence does not support systematic antibiotherapy prior to joint arthroplasty in patients with asymptomatic bacteriuria-a meta analysis.
Synthesis in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Is there scientific evidence to support antibiotic prophylaxis in patients with periodontal disease as a means to decrease the risk of prosthetic joint infections? A systematic review.International orthopaedics · 2020Pooled it
- Lack of Benefit on Treating Asymptomatic Bacteriuria Prior to Cardiovascular Surgery: a Systematic Review and Meta-Analysis.Brazilian journal of cardiovascular surgeryPooled it
- Variation of Practice in Prophylactic Protocol to Reduce Prosthetic Joint Infection in Primary Hip and Knee Arthroplasty: A National Survey in the United Kingdom.Hip & pelvis · 2023Article
- Total Hip Replacement for Osteoarthritis-Evidence-Based and Patient-Oriented Indications.Deutsches Arzteblatt international · 2021Review
- Preoperative bacteriuria positivity on urinalysis increases wound complications in primary total hip arthroplasty regardless of the urine culture result.BMC musculoskeletal disorders · 2021Observational
- Asymptomatic Bacteriuria: For How Long Will We Keep Swimming Against The Current?Mayo Clinic proceedings. Innovations, quality & outcomes · 2020Article
- Prominent and fruitful development of orthopaedic research in China.International orthopaedics · 2018Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany orthopaedic surgeons worry about asymptomatic bacteriuria (ASB) as a possible risk factor for prosthetic joint infection (PJI). However, available evidence establishing a direct link between ASB and PJI is limited. This meta-analysis aimed to investigate whether ASB is a factor for PJI and whether pre-operative antibiotic treatment shows benefit.
methodWe systematically searched major databases such as PubMed, Web of Science, the Cochrane Library and EMBASE for studies. Risk ratio (RR) was calculated for included studies that reported raw counts with 95% confidence interval (CI).
resultsFive studies involved 3588 joint arthroplasties and 441 cases of ASB (overall incidence 12.3%). Compared with the control group, PJI was more common in both patients in the ASB group (RR = 2.87; 95% CI, 1.65-5.00). But in all five studies, the micro-organisms isolated from PJI and urine cultures were not the same. Three of the five studies reported that the antibiotic treated the ASB prior to joint arthroplasty and compared the untreated ASB group.There was no significant difference between groups (RR = 0.89; 95% CI, 0.36-2.20). DISCUSSION: PJI occurring via the haematogenous route from the genitourinary tract harbouring bacteria in ASB is impossible. Pre-operative antibiotic treatment has no benefit. A plausible explanation could be an indicator of frailty and increased susceptibility to infection.
conclusionsASB increased the risk of PJI in the meta-analysis. However, current evidence does not support systematic antibiotherapy prior to joint arthroplasty and screening for ASB.
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