Antibiotic Prophylaxis in Orthopaedic Surgery: A Review and Institutional Experience

Surgical site infections (SSIs) are a significant complication in orthopaedic surgery. Effective use of antimicrobial prophylaxis is critical in reducing their incidence without promoting resistance.

To review current evidence on antibiotic prophylaxis in orthopaedic surgery and to analyse data from our institution on the effectiveness of current prophylaxis protocols.

We carried out a literature review and a retrospective analysis of 1,000 orthopaedic surgeries done over a two-year period. The timing and duration of antibiotic prophylaxis and its association with postoperative SSI rates were evaluated. The standard was compared with the current antibiotic prophylaxis guidelines from our trust policy.

Our institutional data demonstrated no statistically significant difference in SSI rates between patients who received 24-hour versus those who received extended antibiotic prophylaxis. Recent literature consistently supports the timely administration of preoperative antibiotics and discourages prolonged use beyond 24 hours. This is in line with our trust policy.

Preoperative administration of a single dose of antibiotic or a maximum of two doses remains effective in preventing SSIs. Extending prophylaxis beyond 24 hours offers no additional benefit and may promote antimicrobial resistance.