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The Journal of Bone and Joint Surgery 78:1755-70 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Prophylactic Use of Antibiotics for Procedures after Total Joint Replacement*

JOHN M. DEACON, B.A.{dagger}, ANDRE J. PAGLIARO, M.D.{dagger}, STEVEN B. ZELICOF, M.D., PH.D.{dagger} and HAROLD W. HOROWITZ, M.D.{dagger}, VALHALLA, NEW YORK

Investigation performed at Departments of Orthopaedic Surgery and Internal Medicine and the Division of Infectious Diseases, New York Medical College, Valhalla


   Introduction
 
In an era of increasing managed care, during which costs are being scrutinized and management algorithms are being initiated at many levels of care, the use of strategies to prevent the development of active disease seems attractive. Treatment with antibiotics to prevent infection is one area where the potential benefits of disease prevention appear to far outweigh the costs. In fact, because they are relatively inexpensive and they can be administered easily, antibiotics are frequently administered prophylactically before procedures that might lead to bacteremia.

The prophylactic use of antibiotics when an invasive procedure is performed in patients who have a prosthetic joint has been the subject of intense debate10,21,25,54,66,84,85,103,107,144,156,162. It has been estimated that as many as 500,000 total joint replacements are performed each year in the United States49, and this number is expected to grow as the population ages. Most of these replacements involve the lower extremities, . . . [Full Text of this Article]


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