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Single-dose antibiotics reduced infection rates in patients with hip fractures
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Orthopaedic investigators have found that a single dose of gentamicin and amoxicillin significantly reduced the need for postoperative antibiotics following hip hemiarthroplasty, compared with three doses of a second-generation cephalosporin antibiotic.
“We suggest that single-dose antibiotic prophylaxis is as effective as multiple-dose regimes, [it] cuts down the rate of Clostridium difficile, and is more cost effective,” Richard P. Jeavons, specialist registrar in trauma and orthopaedics, Sunderland Royal Hospital, Sunderland, U.K., told Orthopaedics Today Europe prior to the presentation of his study at the EFORT Congress 2010.
Single vs. triple dose
Jeavons and colleagues performed a retrospective review of 220 patients following hip hemiarthroplasty. A single dose of gentamicin and amoxicillin was administered to 107 patients, and 113 patients received three doses of cefuroxime, according to the study abstract.
Average length of hospital was 13 days for patients in the single-dose group, compared with 17 days for those in the triple-dose group. No patients in the single-dose group developed c. difficile infection, compared with seven in the triple-dose group. Postoperative antibiotics were administered to 73 patients in the single-dose group, compared with 99 in the triple-dose group, the abstract noted.
Future study
“Our results did show a significant reduction in the number of patients, with confirmed growth on microbial swabbing of wounds, that actually required antibiotic treatment for wound infection,” Jeavons said.
He stated that the single-dose gentamicin and amoxicillin regime is used for prophylaxis of all trauma patients requiring surgery at his institution, where they have plans to assess the outcomes of this regime across all trauma procedures.
- Reference:
Jeavons RP, Siddiqui B, Jettoo P, et al. Hip fracture antibiotic prophylaxis: 3 dose cefuroxime regime versus single dose gentamicin and amoxicillin. To be presented at the 2010 EFORT Congress. June 2-5, 2010. Madrid.