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Trends in infection prophylaxis in orthopaedics
1Department of Orthopaedic Surgery, Victoria Infirmary, Glasgow, UK.
Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1992
Summary
Orthopaedic surgeons in Scotland are increasingly using systemic antibiotic prophylaxis for joint replacements and fracture fixation. However, over half of surgeons exceed recommended antibiotic durations for elective procedures, potentially leading to unnecessary exposure.
Area of Science:
- Orthopaedic surgery
- Infection prevention
- Pharmacology
Background:
- Antibiotic prophylaxis is crucial in preventing surgical site infections.
- Previous studies have documented antibiotic use in Scottish orthopaedic surgery.
- Adherence to established guidelines for antibiotic duration is essential.
Purpose of the Study:
- To assess current practices in antibiotic prophylaxis among Scottish consultant orthopaedic surgeons.
- To compare contemporary antibiotic use with data from a similar study conducted five years prior.
- To identify trends in antibiotic selection and duration for common orthopaedic procedures.
Main Methods:
- A national postal questionnaire survey of consultant orthopaedic surgeons in Scotland.
- Comparison of current findings with historical data from a similar survey.
- Analysis of antibiotic prophylaxis practices for total hip arthroplasty, compound fractures, and internal fixation of closed fractures.
Main Results:
- Increased use of routine systemic antibiotic prophylaxis for total hip arthroplasty (99% vs. 91%), compound fractures (89% vs. 75%), and internal fixation (49% vs. 12%) compared to five years ago.
- Growing preference for cephalosporins as the antibiotic of choice.
- Over 50% of surgeons administer antibiotics longer than recommended for elective surgery, either by starting before surgery or continuing beyond 24 hours post-operatively.
Conclusions:
- Scottish orthopaedic surgeons demonstrate an increasing trend towards antibiotic prophylaxis for various procedures.
- There is a notable rise in the use of cephalosporins.
- A significant proportion of surgeons may be over-administering antibiotics, exceeding recommended durations for elective procedures, highlighting a need for guideline reinforcement.