Topical vancomycin seen as efficacious, cost-effective for primary total hip arthroplasty
Topical vancomycin for total hip arthroplasty is inexpensive and cost-effective, according to recently published results, which found patients treated with it had a lower infection rate.
“Currently, the use of topical antibiotics in total joint arthroplasty is a topic of debate with limited studies,” Eric M. Cohen, MD, told Healio.com/Orthopedics. “Our study found that topical vancomycin is inexpensive and cost-effective and, although not statistically significant, the topical vancomycin group had a 60% lower incidence of infection.”
Researchers performed a retrospective chart review for patients who underwent cementless total hip arthroplasties. There were 309 patients who were treated with topical vancomycin and 246 patients did not receive the treatment. The absolute reduction threshold needed for topical vancomycin to be cost-effective was determined with the costs of vancomycin and postoperative infection.
Results showed infection in two patients treated with vancomycin and in four patients who were not treated with vancomycin. No statistical difference was seen between the treatment groups with regard to the infection rate. Investigators noted the absolute risk reduction was 0.98%. The number required to treat with topical vancomycin was 102 patients in order to prevent one periprosthetic joint infection. Per patient, topical vancomycin had an expected cost savings of $904.
“I do believe prior to widespread adoption of this practice, further studies are needed on the efficacy of topical vancomycin in prevention of periprosthetic joint infection and the potential consequences of routine topical antibiotic use in total joint arthroplasty,” Cohen said. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.