NEW ORLEANS — Use of extended postoperative oral antibiotic prophylaxis in select patients who underwent total joint arthroplasty and had a high risk for infection statistically significantly reduced the 90-day infection rate, according to a presenter at the American Academy of Orthopaedic Surgeons.
“The purpose of this study is not to suggest adoption of antibiotics for all of our patients for TJA,” Avinash Inabathula, MD, said during the presentation. “This data indicates there may be a place for extended prophylaxis beyond the traditional 24-hour period.”
In a retrospective cohort study, Inabathula and colleagues identified 2,256 TJAs from 2011 to 2016 performed in an academic hospital using modern perioperative and infection prevention protocols. In January 2015, they initiated extended oral antibiotic prophylaxis for 7 days after discharge in patients who had a high risk of developing periprosthetic joint infection (PJI).
Investigators found 1,350 patients developed one or more risk factors for PJI. Investigators noted 34.7% of patients were discharged on extended prophylactic antibiotics.
After 90 days, the periprosthetic infection overall was 1.5%. The infection rates for patients without risk factors, high-risk patients without extended antibiotics and high-risk patients discharged on extended antibiotic prophylaxis were 1.1%, 3% and 0.6%, respectively.
According to researchers, a periarticular injection with liposomal bupivacaine was the only non-protocol factor linked with an increase in the infection rate. – by Monica Jaramillo
Inabathula A, et al. Paper # 132. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.
Disclosure: Inabathula reports no relevant financial disclosures.