Reduced re-infection rates with postoperative oral antibiotics after two-stage revision hip arthroplasty

BMC Musculoskeletal Disorders

Michael A Mont²  D Alex Stroh²  Ronald E Delanois²  Lynne C Jones¹  Michael G Zywiel²  Aaron J Johnson² 

[1] Johns Hopkins Orthopaedics at Good Samaritan Hospital, 5601 Loch Raven Boulevard, Baltimore, MD, USA;Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, USA

关键词: Re-infection rates;    Antibiotic;    Total hip arthroplasty;    THA;    Peri-prosthetic infection;   

Others  :  1132995
DOI  :  10.1186/1471-2474-14-123

 received in 2012-04-27, accepted in 2013-03-19,  发布年份 2013

【 摘 要 】

Background

Surgeons are often trying to decreased reinfection rates following two-stage reimplantation arthroplasty, which range from 3.2% to 13% because multiple staged revision procedures for infection can be costly and have high morbidity. We therefore asked: (1) Did the use of postoperative oral antibiotics reduce reinfection rates after 2-staged revision of THA? And (2) how did this compare with the infection rate after aseptic revision procedures?

Methods

We identified all patients who underwent two-stage revision THA for a periprosthetic deep hip infection and found 66 patients (67 hips) who had a minimum 24 months’ followup. Twenty-two of the 66 procedures (33%) were followed by a minimum of 14 days of postoperative oral antibiotics (mean, 36 days; range, 14 days to lifelong), while 44 were prescribed only immediate parenteral postoperative antibiotic therapy (mean, 1.3 days; range, 1–3 days). We then identified 407 patients (410 hips) who underwent aseptic revision hip arthroplasty and evaluated the infection rate in these patients for comparison; these patients were treated with 24 hours of postoperative parenteral antibiotics. The authors used previously described creteria to establish the presence of infection.

Results

There were no reinfections in the group receiving oral postoperative antibiotics compared to six reinfections (13.6%) in the 44 patients not receiving oral antibiotics. We observed infection in 2 of the 410 hips (0.5%) revised for aseptic reasons.

Conclusions

We believe that our findings warrant further investigation for using postoperative oral antibiotics after reimplantation for periprosthetic infection in an effort to decrease the likelihood and risks associated with additional revision arthroplasty procedures.

【 授权许可】

   
2013 Johnson et al.; licensee BioMed Central Ltd.

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