Antibiotic prophylaxis regimens in TKA and THA surgeries in the United Kingdom

Total hip (THA) and knee (TKA) arthroplasty are becoming increasingly frequent nowadays due to the aging of the population. Although with excellent results most of the time, infection is one of the most common complications and antibiotic prophylaxis is one way to try to reduce the chance of this complication.

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Antibiotic regimens vary by country and hospital, and there is no consensus on which is best. It was published in the magazine last month Bone and joint are open A study to identify antibiotic prophylaxis regimens currently in use for elective primary arthroplasty across the UK, establish their variations and their impact on the risk of periprosthetic joint infection (PJI) in the first year post-procedure, and assess adherence to current international consensus guidelines.

A review of antibiotic prophylaxis

Antibiotic regimens established in 109 British hospitals were evaluated in terms of dosage and number of subsequent doses, in addition to the type of antibiotic used. The average cost of each plan was calculated using the “British National Formulary”.

The primary choice and dose of prophylactic antimicrobial regimens vary widely. Teicoplanin and gentamicin were the two most commonly used regimens, and cefuroxime and two or three doses of cefuroxime every eight hours were recommended by 24 centers (22.02%) each. Alternative choice and dose of prophylactic antimicrobial regimens varied widely among the 83 centers with available data.

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Prophylactic regimens in some centers fail to cover most causes of surgical site infection (SSI). Five centers (4.59%) prescribed amoxicillin with clavulanate, which did not provide coverage for Staphylococcus, while 33 centers (30.28%) prescribed cefuroxime, which did not provide coverage for Enterococcus.