Abstract
A controlled prospective trial to compare the efficacy of the antibiotics cephaloridine and flucloxacillin in preventing infection after total hip replacement was conducted at three hospitals. The antibiotic regimens began before surgery, cephaloridine being continued for 12 hours and flucloxacillin for 14 days afterwards. Over an 18-month period 297 patients undergoing a total of 310 hip replacements were entered into the trial and randomly allocated to one of the regimens. The follow-up period ranged from one to two and a half years. All operations were performed in conventional operating theatres; at two of the hospitals these were also used by various other surgical disciplines. Four patients developed deep infection, two having received the cephaloridine and two the flucloxacillin regimen. The overall rate of deep infection was therefore 1.3%. Thus three doses of cephaloridine proved to be as effective as a two-week regimen of flucloxacillin. Giving a prophylactic systemic antibiotic reduced the incidence of infection to a level comparable with that obtained in ultra-clean-air operating enclosures.
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- Benson M. K., Hughes S. P. Infection following total hip replacement in a general hospital without special orthopaedic facilities. Acta Orthop Scand. 1975 Dec;46(6):968–978. doi: 10.3109/17453677508989286. [DOI] [PubMed] [Google Scholar]
- Charnley J. Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop Relat Res. 1972 Sep;87:167–187. doi: 10.1097/00003086-197209000-00020. [DOI] [PubMed] [Google Scholar]
- Ericson C., Lidgren L., Lindberg L. Cloxacillin in the prophylaxis of postoperative infections of the hip. J Bone Joint Surg Am. 1973 Jun;55(4):808-13, 843. [PubMed] [Google Scholar]
- Evans C., Pollock A. V. The reduction of surgical wound infections by prophylactic parenteral cephaloridine. A controlled clinical trial. Br J Surg. 1973 Jun;60(6):434–437. doi: 10.1002/bjs.1800600605. [DOI] [PubMed] [Google Scholar]
- Finegold S. M., Rosenblatt J. E. Practical aspects of anaerobic sepsis. Medicine (Baltimore) 1973 Jul;52(4):311–322. doi: 10.1097/00005792-197307000-00010. [DOI] [PubMed] [Google Scholar]
- Harris J., Lightowler C. D., Todd R. C. Total hip replacement in inflammatory hip disease using the Charnley prosthesis. Br Med J. 1972 Jun 24;2(5816):750–752. doi: 10.1136/bmj.2.5816.750. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patterson F. P., Brown C. S. The McKee-Farrar total hip replacement. Preliminary results and complications of 368 operations performed in five general hospitals. J Bone Joint Surg Am. 1972 Mar;54(2):257–275. [PubMed] [Google Scholar]
- Pavel A., Smith R. L., Ballard A., Larsen I. J. Prophylactic antibiotics in clean orthopaedic surgery. J Bone Joint Surg Am. 1974 Jun;56(4):777–782. [PubMed] [Google Scholar]
- Polk H. C., Jr, Lopez-Mayor J. F. Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery. 1969 Jul;66(1):97–103. [PubMed] [Google Scholar]
- Sutherland R., Croydon E. A., Rolinson G. N. Flucloxacillin, a new isoxazolyl penicillin, compared with oxacillin, cloxacillin, and dicloxacillin. Br Med J. 1970 Nov 21;4(5733):455–460. doi: 10.1136/bmj.4.5733.455. [DOI] [PMC free article] [PubMed] [Google Scholar]