Antibiotics and antiseptics for preventing infection in people receiving revision total hip and knee prostheses: a systematic review of randomized controlled trials

BMC Infectious Diseases

Research Article

Jeffrey Voigt¹  Rabih Darouiche²  Michael Mosier³ 

[1] 99 Glenwood Rd, 07450, Ridgewood, NJ, USA;Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd # 128, 77030, Houston, TX, USA;Washburn University, Morgan Hall, Room 250 J, 1700 SW College Ave, 66621, Topeka, KS, USA;

关键词: Antibiotic Prophylaxis;    Daptomycin;    Tigecycline;    Mupirocin;    Revision Procedure;   

DOI  :  10.1186/s12879-016-2063-4

 received in 2016-02-15, accepted in 2016-11-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundInfection rates in revision (second and subsequent) major joint arthroplasty continues to be a significant issue with rates 2–3 times those of primary procedures. The effect of antibiotic and antiseptic prophylaxis on outcomes for this type of surgery has not been adequately reviewed.MethodsA systematic search of the main databases for randomized controlled trials (RCTs) evaluating antibiotics and antiseptics was conducted to evaluate the predetermined endpoints of infection.ResultsThere were five (5) RCTs identified that examined the effects of antibiotic and antiseptic prophylaxis on infections after revision total hip arthroplasty [THA] (total of 304 participants) and total knee arthroplasty [TKA] (total of 206 participants). For TKA, preoperative systemic intravenous (IV) antibiotic prophylaxis plus antibiotic cement may be effective in reducing the incidence of infection in revision TKA at 8+ years. These results however should be interpreted with caution due to the significant biases. For revision THA, there is no RCT evidence that antibiotics/antiseptics have any effect on the infection rate.ConclusionsThere is a lack of high quality data demonstrating an effect of antibiotics or antiseptics on infection rates in revision THA/TKA. Considering the rate of infections in revisions is 2-3X that of primary procedures and; there is a consensus recommendation to use similar antibiotic and antiseptic regimens in both primary and revision procedures, there is a need for high quality studies in revision THA/TKA.

【 授权许可】

CC BY   
© The Author(s). 2016