Evidence map›Paper›PMID 40959005›Full record

ArticleJSES international2025

Non-cefazolin antibiotic prophylaxis is associated with increased rates of acute infectious, medical, and surgical complications following primary total shoulder arthroplasty: a database study.

Ryan D Freshman, Amir Fathi, Matthew Orringer, Jacob L Kotlier, Cory K Mayfield, Eric H Lin, Cailan L Feingold, Frank A Petrigliano, Joseph N Liu

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Article in JSES international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

2 · The registry

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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

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Ryan D FreshmanDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Amir FathiDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Matthew OrringerDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Jacob L KotlierDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Cory K MayfieldDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Eric H LinDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Cailan L FeingoldDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Frank A PetriglianoDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Joseph N LiuDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hypothesis: This study aimed to evaluate different prophylactic antibiotic regimens and risk for acute postoperative readmissions, infections, and medical complications. Methods: This retrospective cohort study used the Premier Healthcare Database to identify patients who underwent primary elective shoulder arthroplasty procedures over the age of 18. The database was queried to identify perioperative antibiotic regimens using specific codes for cefazolin, clindamycin, and vancomycin. Patients receiving cefazolin monotherapy for prophylactic antibiotic regimen were used as a control group and multivariate logistic regression was then used to calculate odd ratios for postoperative complications within 90 days of the procedure. Results: A total of 139,032 patients undergoing primary shoulder arthroplasty between 2016 and 2020 were included. Cefazolin monotherapy was the most prescribed antibiotic regimen (59.3%), followed by vancomycin and cefazolin combination therapy (23.3%), vancomycin monotherapy (8.6%), clindamycin monotherapy (5.6%), and vancomycin and clindamycin combination therapy (3.2%). Monotherapy with clindamycin or vancomycin was associated with increased risk of periprosthetic joint infection ( Conclusion: Compared to vancomycin and clindamycin monotherapy, cefazolin monotherapy was associated with a lower risk of developing acute postoperative periprosthetic joint infection. The results of this study support the use of cefazolin monotherapy as the current standard for patients undergoing primary total shoulder arthroplasty.

Indexed as

Antibiotic prophylaxisCefazolin monotherapyClindamycinDatabasePrimary total shoulder arthroplastyVancomycin

Identifiers

PMID40959005
PMCPMC12434980

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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.