More antibiotics don't prevent joint replacement infections: Study

As the U.S. anticipates an increase in knee and hip replacement surgeries, adding a second antibiotic does not help prevent postoperative infections and can even spur adverse events, according to a recent study.

An Australia-based study evaluated more than 4,000 patients who underwent total joint operations. The patients received cefazolin, an antibacterial drug, and half were given another antibacterial, vancomycin, or a placebo. The research was published Oct. 19 in The New England Journal of Medicine

Within 90 days after the surgery, 163 surgical site infections were diagnosed among the 4,113 patients. Ninety-one of 2,044 patients (4.5%) received vancomycin and 72 of 2,069 (3.5%) took a placebo. 

Surgical-site infections after knee replacements and vancomycin were more common than infections after hip replacements and vancomycin: 5.7% with a second antibiotic versus 3.7% among the placebo group for knee replacements, and 3.0% versus 3.1% for hip replacements.

"Given the number of joint replacements performed in Australia and globally, our trial has answered the important [question] about whether more antibiotics are better for our patients having joint replacement surgery: with the definitive answer being 'no,'" Trisha Peel, MD, PhD, the lead author of the study, said in a news release. "This trial will have a significant impact on practice."

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