Articles | Volume 9, issue 1
https://doi.org/10.5194/jbji-9-67-2024
https://doi.org/10.5194/jbji-9-67-2024
Original full-length article
 | 
15 Feb 2024
Original full-length article |  | 15 Feb 2024

Antibiotic prophylaxis before tissue biopsy has no effect on culture results in presumed aseptic revision total hip arthroplasty

Jesse D. De Groot, Roy G. B. Brokelman, Bas L. Fransen, Tim U. Jiya, and Dean F. M. Pakvis

Related subject area

Subject: Prosthesis-related infections | Topic: Antibiotic therapy
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Cited articles

Abad, C. L. and Haleem, A.: Prosthetic Joint Infections: an Update, Curr. Infect. Dis. Rep., 20, 15, https://doi.org/10.1007/s11908-018-0622-0, 2017. 
Alizadeh, M., Yousefi, L., Pakdel, F., Ghotaslou, R., Rezaee, M. A., Khodadadi, E., Oskouei, M.A., Soroush Barhaghi, M., and Kafil, H. S.: MALDI-TOF Mass Spectroscopy Applications in Clinical Microbiology, Adv. Pharmacol. Pharm. Sci., 2021, 9928238, https://doi.org/10.1155/2021/9928238, 2021. 
Al-Mayahi, M., Cian, A., Lipsky, B. A., Suvà, D., Müller, C., Landelle, C., Miozzari, H., and Uçkay, I.: Administration of antibiotic agents before intraoperative sampling in orthopedic infections alters culture results, J. Infect., 71, 518–525, https://doi.org/10.1016/j.jinf.2015.08.002, 2020. 
Badarudeen, S., Shu, A. C., Ong, K. L., Baykal, D., Lau, E., and Malkani, A. L: Complications After Revision Total Hip Arthroplasty in the Medicare Population, J. Arthroplasty, 32, 1954–1958, https://doi.org/10.1016/j.arth.2017.01.037, 2017. 
Bakker, E. C. M., Duteweert, D., and De Groot, J. D.: Statistical Software Code for AP R-THA study (Final Version), Figshare [code], https://doi.org/10.6084/m9.figshare.25187648, 2024. 
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Short summary
We retrospectively analyzed 490 patients who underwent aseptic revision total hip replacement (R-THA) and found no difference in culture results between antibiotic prophylaxis (AP) administered before incision or after tissue biopsy. Although not significant, infection was twice as likely when AP was given after incision. Other literature also supports the benefit of pre-incisional AP. We therefore believe AP should be given pre-incision to prevent unnecessarily exposing patients to infections.