Single dose cefazolin is safe and effective for pre-operative prophylaxis in orthopaedic oncology

A Ziranu, M Lillo, M Fantoni, N Maffulli, G Maccauro

Article ID: 6380
Vol 32, Issue 6S1, 2018
DOI: https://doi.org/10.54517/jbrha6380
Received: 8 January 2019; Accepted: 8 January 2019; Available online: 8 January 2019; Issue release: 8 January 2019

Abstract

Surgical site infections (SSI) are a common potentially preventable complication after surgical procedures. A standardized antibiotic prophylaxis in elective orthopaedic surgery plays a major role in lowering SSI. At present, there is little published evidence regarding standardized antibiotic prophylaxis in orthopaedic oncological surgery. We introduced a prophylactic antibiotic protocol for orthopaedic oncological surgery in our hospital. The proposed protocol consists in "one-shot" intravenous administration of Cefazolin 2g, 30 min before surgery. In our setting, this preoperative antibiotic prophylaxis regimen was associated with a markedly lower rate of SSIs. There is no current evidence in favour of greater effectiveness of prophylaxis beyond 24/48 h after surgery compared to our pre-surgical "one-shot" administration; by contrast, prolonged post-surgical prophylaxis is likely to undermine the patients bacterial flora and select resistant pathogens. These results are preliminary and should be used to start planning a standardised prophylactic protocol to prevent SSIs after orthopaedic oncological surgery.


Keywords

orthopedic oncological surgery;surgical site infection;antibiotic prophylaxis;cefazolin


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