Higher cefazolin dose does not decrease surgical site infection after foot, ankle surgery
Published results showed no statistically significant differences in the rate of surgical site infections after foot and ankle trauma surgery with use of 1g or 2g of cefazolin.
Tim Schepers, MD, PhD, of Amsterdam UMC, University of Amsterdam, Trauma Unit, Amsterdam, the Netherlands, and colleagues compared the primary outcome of incidence of surgical site infection after trauma-related surgery of the foot, ankle or lower leg between patients who received either 1g (n = 293) or 2g (n = 126) of cefazolin as surgical prophylaxis. Researchers used a propensity score to correct for possible confounders.
Results showed surgical site infection occurred in 6.5% and 4.8% of patients who received 1g and 2g of cefazolin, respectively. However, researchers found this difference was not statistically significant after correcting for possible confounders.
Although the findings of this study were not statistically significant, Schepers noted “they might be clinically relevant in light of patient satisfaction and health care costs.” He added the target site concentration of antibiotics may be the rationale behind the small difference in surgical site infections, with previously published research showing lower levels of antibiotics in more distal areas of the body.
“Future research should focus on the levels of antibiotics that reach the foot and ankle to see whether or not they are sufficiently high, or to investigate other means to increase the concentration of antibiotics at the most distal part of the body and, thereby, hopefully, lower the complication rates found in foot and ankle trauma surgery,” Schepers told Healio Orthopedics.