Prophylactic antibiotics in elective orthopedic surgery: a prospective study of 1,591 cases

A double-blind prospective study involving 1,591 clean orthopedic surgical procedures was done to test the effectiveness of preoperative and intraoperative antibiotics in reducing the postoperative infection rate. The antibiotic and placebo groups were analyzed carefully for factors known to predispose to infection. Several minor exceptions were noted, but generally the antibiotic and placebo groups were comparable with regard to these factors. A decrease in overall postoperative infection rate from 5.0% in the placebo group to 2.8% in the antibiotic group was found. In specific areas such as the hip and spine a much greater reduction in postoperative wound infections occurred than in the group as a whole.