The current recommendation in Norway is to use four doses of a first-generation cephalosporin (cefazolin or cephalotin) as systemic antibiotic prophylaxis (SAP) the day of surgery in primary joint arthroplasty. Due to shortage of supply, scientific development, changed courses of treatment and improved antibiotic stewardship, this recommendation has been disputed. We therefore wanted to assess if one dose of SAP was non-inferior to four doses in preventing periprosthetic joint infection (PJI) in primary joint arthroplasty. We included patients with primary hip- and knee arthroplasties from the Norwegian Arthroplasty Register and the Norwegian Hip Fracture Register for the period 2005-2023. We included the most used SAPs (cephalotin, cefazolin, cefuroxime, cloxacillin and clindamycin), administered as the only SAP in 1-4 doses, starting preoperatively. Risk of revision (Hazard rate ratio; HRR) for PJI was estimated by Cox regression analyses with adjustment for sex, age, ASA class, duration of surgery, reason for- and type of arthroplasty, and year of primary arthroplasty. The outcome was 1-year reoperation or revision for PJI. Non-inferiority margins were calculated for 1, 2 and 3 doses versus reference of 4 doses of SAP at the day of surgery, against a predetermined limit of 15% increased risk of PJI.Aim
Method
In recent years, many studies on We investigated the reported Aim
Methods
To see what surgical strategy was used in treating infected total hip arthroplasties (THA), relative to bacterial findings, level of inflammation, length of antibiotic treatment (AB) and re-revisions. Further, to assess the results of treatment after three months and one year. We used our national arthroplasty register (NAR) to identify THA revised for deep infection from 2004–2015 reported from our hospital. We identified the strategy of revision, i.e. one-stage exchange (one-stage), two-stage exchange (two-stage), debridement and implant retention (DAIR), or Girdlestone, and reported re-revisions for infection. We defined cure as no AB, no need for further surgery and joint with prosthesis (not Girdlestone). From the hospitals’ medical records we retrieved bacterial findings from the revisions, level of C-reactive protein (CRP), type of antibiotics given, duration of antibiotic therapy and clinical data regarding the patients. The information reported to the NAR was also validated.Aim
Method
