Evidence map›Paper›PMID 40827944›Full record

SynthesisActa orthopaedica2025

Comparative effectiveness of antibiotic prophylaxis for preventing serious adverse events after primary total hip arthroplasty: a systematic review and network meta-analysis of randomized trials.

Armita A Abedi, Jacob M Svensson, Alma B Pedersen, Claus Varnum, Sabrina M Nielsen, Jens H Laigaard, Robin Christensen, Søren Overgaard

Abstract readComparative StudyNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Acta orthopaedica, 2025. 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
–field-weighted citation impact
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.

  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.

Armita A AbediDepartment of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. armita.armina.abedi@regionh.dk.
Jacob M SvenssonDepartment of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0002-4896-1519
Alma B PedersenDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.ORCID 0000-0002-3288-9401
Claus VarnumDepartment of Orthopaedic Surgery, Lillebaelt Hospital, Vejle; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.ORCID 0000-0002-0625-5691
Sabrina M NielsenSection for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark.
Jens H LaigaardDepartment of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Robin Christensen *Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark.ORCID 0000-0002-6600-0631
Søren Overgaard *Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0001-6829-4787

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe optimal duration of antibiotic prophylaxis for reducing serious adverse events (SAEs) after total hip arthroplasty (THA) is unclear. We aimed to assess the comparative effectiveness of different strategies of antibiotic prophylaxis in preventing SAEs after THA.

methodsWe searched Medline, Embase, CENTRAL, and the Clinical Trial Registration Database for randomized controlled trials evaluating antibiotic prophylaxis in patients undergoing primary THA. Two authors independently screened, extracted data, and assessed the risk of bias. We defined SAEs as prosthetic joint infections, other serious infections, major cardiovascular events, venous thromboembolisms, or mortality. The primary summary measures were odds ratios (ORs) with 95% confidence intervals (CI). The evidence was assessed using the confidence in network meta-analysis (CINeMA) framework.

resultsOf 6,131 identified citations, 10 trials of 2-group comparisons were included, involving 9,106 patients. Duration of antibiotics was grouped as follows: placebo (3), a single dose (3), multiple doses ≤ 24 hours (6), multiple doses (> 1 day) (6), and bone cement with antibiotics (2). Compared with placebo, point estimates suggest lower odds of SAEs after THA for most antibiotic strategies, except multiple doses > 1 day. Multiple doses showed no clear evidence of superiority to single dose: OR (multiple doses ≤ 24 hours) = 0.87 (CI 0.20-3.73; very low) or over more days (> 1 day) OR = 0.40 (CI 0.07-2.42; very low) nor were multiple doses > 1 day superior to multiple doses ≤ 24 hours, OR = 0.46 (0.11-1.90; very low).

conclusionRelative to placebo, point estimates suggested that most antibiotic prophylaxis regimens may reduce SAEs after THA, with no clear evidence of added benefit from multiple doses. These findings should be interpreted with caution due to the lack of precision and the corresponding very low certainty of evidence for some comparisons.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisArthroplasty, Replacement, HipPostoperative ComplicationsProsthesis-Related InfectionsHumansRandomized Controlled Trials as TopicAnti-Bacterial Agents

Identifiers

PMID40827944
PMCPMC12362941

What OpenQuestion holds

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Registered trials

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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.