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There is considerable variation in antibiotic prophylaxis protocols, with intravenous (IV) first-generation cephalosporins being the most commonly implemented antibiotic to prevent periprosthetic joint infection (PJI). Individuals treated with IV extended antibiotic prophylaxis (EAP) are less likely to develop a PJI relative to those treated with the standard of care for all total joint arthroplasty (TJA). Multiple doses add no additional benefit for individuals with a high preoperative risk of PJI. It seems safe to use clindamycin in penicillin- or cephalosporin-allergic individuals. Late infusion of vancomycin is frequent and associated with increased rates of infectious causes for readmission and PJI. Intraosseous (IO) vancomycin might be considered for primary THA.

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Antibiotic Prophylaxis in Total Knee Arthroplasty: Its Role in Decreasing Periprosthetic Joint Infection Rates

  • 章节

  • 发表日期：

    2025年

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  • E. Carlos Rodríguez-Merchán,
  • Juan S. Ruiz-Pérez,
  • Primitivo Gómez-Cardero

摘要

There is considerable variation in antibiotic prophylaxis protocols, with intravenous (IV) first-generation cephalosporins being the most commonly implemented antibiotic to prevent periprosthetic joint infection (PJI). Individuals treated with IV extended antibiotic prophylaxis (EAP) are less likely to develop a PJI relative to those treated with the standard of care for all total joint arthroplasty (TJA). Multiple doses add no additional benefit for individuals with a high preoperative risk of PJI. It seems safe to use clindamycin in penicillin- or cephalosporin-allergic individuals. Late infusion of vancomycin is frequent and associated with increased rates of infectious causes for readmission and PJI. Intraosseous (IO) vancomycin might be considered for primary THA.