Abstract

KIGERA, JWM  and  GAKUO, LN. Is there a role for prolonged post-operative antibiotic use in primary total hip arthroplasty in the African setting?. SA orthop. j. [online]. 2013, vol.12, n.4, pp.38-40. ISSN 2309-8309.

INTRODUCTION: The use of prophylactic antibiotics to reduce the risk of surgical site infection (SSI) is recommended for up to 24 hours post-operatively. Surgeons in Africa have been using antibiotics for prolonged periods of time because of perceived higher infection rates. We conducted a study to determine the incidence of early post-operative SSI and to determine if the use of antibiotics beyond 24 hours post-operatively resulted in any difference in this incidence after primary total hip arthroplasties. METHODS: A retrospective cohort study was conducted of all primary total hip arthroplasties done from 1998 to 2011. Patients had a prophylactic administered 30-60 minutes prior to surgical incision and the post-operative antibiotic regime was surgeon-dependent. The study was approved by the hospital Ethics Committee. RESULTS: The overall incidence of post-operative SSI was 1.5%. The duration of prophylactic antibiotic use among patients who were not treated for an SSI averaged 3.39 days (SD 7.496) and ranged from 0 to 65 days. There was no statistical difference in the incidence of post-operative SSI in patients who received prophylactic antibiotics for up to 24 hours (1.4%) and in patients who received antibiotics for longer than 24 hours (2%) (p=0.706). CONCLUSION: The risk of post-operative SSI after total hip arthroplasties is low. There is no evidence to support the use of prophylactic antibiotics for longer than 24 hours even in the African setting.

Keywords : post-operative; surgical site infection; arthroplasty; primary total hip.

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