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Infection Risk-Adjusted Antibiotic Prophylaxis Strategies in Arthroplasty: Short Review of Evidence and Experiences of a Tertiary Center in Spain

Authors Sanz-Ruiz P, Berberich C

Received 31 March 2020

Accepted for publication 21 June 2020

Published 6 August 2020 Volume 2020:12 Pages 89—96

DOI https://doi.org/10.2147/ORR.S256211

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Clark Hung


Pablo Sanz-Ruiz,1 Christof Berberich2

1Department of Orthopedics & Traumatology, University Hospital Gregorio Maranon, Madrid, Spain; 2Department of Medical Training, Heraeus Medical GmbH, Wehrheim, Germany

Correspondence: Christof Berberich
Department of Medical Training, Heraeus Medical GmbH, Philipp-Reis-Str. 8/13, Wehrheim 61273, Germany
Tel +49 6181 352996
Fax +49 6181 352916
Email christof.berberich@heraeus.com

Abstract: There is growing body of evidence that important patient-, procedure- and pathogen-related factors are linked to higher risks for prosthetic joint infections (PJI) following arthroplasty surgeries. The prior identification and optimization of such risk factors is considered paramount to minimize the incidence of these infections. Without any doubt, antibiotic prophylaxis remains one of the cornerstones among all preventive measures. However, the ideal antibiotic prophylaxis is still in debate and discussions have emerged, whether certain situations deserve adjustments or variations of the standard protocol taking into account antibiotic resistance surveillance data and patient risk factors for infections. This review aims to provide the reader with an overview of possible antibiotic prophylaxis strategies in response to these risks and discusses the clinical experiences so far obtained. We further present preliminary evidence that the use of a reinforced local antibiotic prophylaxis regimen with high-dose dual antibiotic-loaded bone cement may be an effective and easy-to-apply option in patients at high infection risks.

Keywords: arthroplasty, prosthetic joint infection, antibiotic prophylaxis, risk for infection, risk-adjustment, extension of prophylaxis, dual prophylaxis, antibiotic-loaded bone cement

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