Evidence map›Paper›PMID 36070795›Full record

ArticlePharmacoepidemiology and drug safety2023

Antibiotic utilisation in primary and revision total hip replacement patients: A registry linkage cohort study of 106 253 patients using the Australian Orthopaedic Association National Joint Replacement Registry.

Richard N de Steiger, Nicole L Pratt, Aarti Gulyani, Katherine M Duszynski, Maria C Inacio, Stephen E Graves, Paul N Smith, Improving Joint Replacement Outcomes in Australia using National Data Linkage Study Working Group

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Richard N de SteigerDepartment of Surgery, Epworth Healthcare, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-1276-2040
Nicole L PrattQuality Use of Medicines and Pharmacy Research Centre, Clinical and Health Services, University of South Australia, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0001-8730-8910
Aarti GulyaniQuality Use of Medicines and Pharmacy Research Centre, Clinical and Health Services, University of South Australia, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0003-3388-1476
Katherine M DuszynskiQuality Use of Medicines and Pharmacy Research Centre, Clinical and Health Services, University of South Australia, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0003-3532-7233
Maria C InacioRegistry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0001-8261-2665
Stephen E GravesAustralian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-1629-319X
Paul N SmithAustralian National University Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.ORCID https://orcid.org/0000-0001-6891-5694
Improving Joint Replacement Outcomes in Australia using National Data Linkage Study Working Group
University of South Australia · AUAustralian National University · AUAustralian Orthopaedic Association · AUSouth Australian Health and Medical Research Institute · AUThe University of Melbourne · AU

Funding

Australian National Health & Medical Research Council Project Grant APP1148106The Hospital Research Foundation
6 · The paper itself

Abstract

purposeInfection is a major complication following joint replacement (JR) surgery. However, little data exist regarding antibiotic utilisation following primary JR and how use changes with subsequent revision surgery. This study aimed to examine variation in antibiotic utilisation rates before and after hip replacement surgery in those revised for infection, revised for other reasons and those without revision.

methodsThis retrospective cohort analysis used linked data from the Australian Orthopaedic Association National Joint Replacement Registry and Australian Government Pharmaceutical Benefits Scheme. Patients were included if undergoing total hip replacement (THR) for osteoarthritis in private hospitals between 2002 and 2017. Three groups were examined: primary THR with no subsequent revision (n = 102 577), primary THR with a subsequent revision for reasons other than periprosthetic joint infection (PJI) (n = 3156) and primary THR with a subsequent revision for PJI (n = 520). Monthly antibiotic utilisation rates and prevalence rate ratios (PRRs) with 95% confidence intervals (CIs) were calculated in the 2 years pre- and post-THR.

resultsPrior to primary THR antibiotic utilisation was 9%-10%. After primary THR, antibiotic utilisation rates were higher among patients revised for PJI (PRR 1.69, 95% CI 1.60-1.79) compared to non-revised patients, while the utilisation rate was lower in patients revised for reasons other than infection (PRR 0.96, 95% CI 0.93-0.98). For those revised for infection, antibiotic utilisation post-revision surgery was two times higher than those revised for other reasons (PRR 2.16, 95% CI 2.08-2.23). Utilisation of injectable antibiotics including, vancomycin, flucloxacillin and cephazolin was higher in those revised for PJI patients 0-2 weeks following surgery but not in those revised for other reasons compared to the non-revised group.

conclusionsOngoing antibiotic utilisation after primary surgery may be an early signal of problems with the THR and should be a prompt for primary care physicians to refer patients to specialists for further appropriate investigations and management.

Indexed as

Arthroplasty, Replacement, HipOrthopedicsProsthesis-Related InfectionsAnti-Bacterial AgentsAustraliaCohort StudiesHumansRegistriesReoperationRetrospective StudiesAnti-Bacterial Agentsantibiotic utilisationdata linkagehip replacementprosthetic joint infectionrevision hip replacement

Identifiers

PMID36070795
PMCPMC10946895
OpenAlexW4291512129

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.