Antibiotic Prophylaxis for Removal of Lower-Extremity Orthopedic Hardware?

In a Dutch trial, preoperative cefazolin did not lower risk for surgical site infection.

Removal of lower-extremity orthopedic implants is considered a “clean” surgical procedure (i.e., without skin contamination or local infection) for which preoperative antibiotic prophylaxis is not normally given. However, relatively high rates of postoperative surgical site infection (SSI) have been reported. To determine if preoperative cefazolin would lower incidence of such SSIs, Dutch researchers conducted a placebo-controlled trial in patients undergoing removal of below-the-knee orthopedic implants at 19 hospitals. Participants were randomized to a single preoperative intravenous 1-g dose of cefazolin (232 patients) or saline (245 patients).

SSI rates were 13.2% in the cefazolin group (29 superficial, 1 deep) and 14.9% in the saline gr…

Reviewing Author

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Antibiotic Prophylaxis for Removal of Lower-Extremity Orthopedic Hardware?

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Reviewing Author