Artikel
Prospective comparative study of Fusidic acid, Vancomycin and Cefuroxime, in prophylactic use in T.H.R. and T.K.R. Early results
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Autoren
Veröffentlicht: | 11. November 2003 |
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Gliederung
Text
Fragestellung
Evaluation of postoperative infections in T.H.R. and T.K.R., after randomized prophylactic use of Fusidic acid, Vancomycin and Cefuroxime and assessment of their side effects.
Methoden
From December 2000 to December 2002, 211 patients, were operated on T.H.R. and T.K.R. in Orthopaedic Department of University of Patras. Mean age was 65.8 y. The patients were categorized into three groups (A, B and C). In group A was administrated Fusidic acid 500mg and Cefuroxime 1.5g preoperatively and 2 doses of Fusidic acid 500mg postoperatively. Group B received Vancomycin 1g and Cefuroxime 1.5g preoperatively and 2 doses of Vancomycin 1g postoperatively. Group C received Cefuroxime 1.5g preoperatively and 2 doses of Cefuroxime 750mg postoperatively. Blood tests were systematically performed preoperatively, and the first and fifth postoperative day. Mean follow up was 13,5 m. (range 2-24 m.).
Ergebnisse
One patient of group B developed deep wound infection. Superficial infections developed 3 pt. (4.4%) of group A, 3 pt. (5.2%) of group B and 2 pt. (2.3%) of group C. Temperature over 38.3o C attributed to another infection site was observed in 6 pt. (8.8%) of group A, 3 pt. (5.2%) of group B and 5 pt. (5.8%) of group C. No side effect was recorded.
Schlussfolgerungen
The proper use of antibiotic prophylaxis according to pharmakokinetic and pharmakodynamic properties combined with sterile surgical techniques prevents early deep wound infections in T.H.R. and T.K.R. The use of specific antistaphylococcal agents is of no benefit in antimicrobial prophylaxis for the above operations.