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The Journal of Bone and Joint Surgery, Vol 76, Issue 1 39-45, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Prophylaxis against infection in total joint arthroplasty. One day of cefuroxime compared with three days of cefazolin
DR Mauerhan, CL Nelson, DL Smith, RH Fitzgerald, TG Slama, RW Petty, RE Jones and RP Evans
Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock 72201.
The efficacy of cefuroxime was compared with the efficacy of cefazolin for
prophylaxis against postoperative wound infection in a prospective,
double-blind, multicenter study of 1354 patients who had had elective
primary or revision total hip or knee arthroplasty. The patients were
randomly assigned to receive either 1.5 grams of cefuroxime followed by 750
milligrams eight and sixteen hours later (for a total of one day of
antibiotic treatment), or one gram of cefazolin every eight hours for nine
doses (for a total of three days of antibiotic treatment). The first dose
of each drug was administered fifteen to sixty minutes before the operative
incision was made (for a primary operation) or after tissue samples had
been obtained for culture (for a revision procedure). After the operation,
the patients were assessed daily while hospitalized and then at two to
three months and one year after the operation. Demographic characteristics
and risk factors were similar in the two groups. For the patients who had
had a primary hip arthroplasty, the rate of deep wound infection was 0.5
per cent (one of 187) for those who had received cefuroxime and 1.2 per
cent (two of 168) for those who had received cefazolin. For the patients
who had had a primary knee arthroplasty, the rate of deep wound infection
was 0.6 per cent (one of 178) for those who had received cefuroxime and 1.4
per cent (three of 207) for those who had received cefazolin.(ABSTRACT
TRUNCATED AT 250 WORDS)
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