Current Concepts Review   |    
Prophylactic Antibiotics in Hip and Knee Arthroplasty
John Meehan, MD1; Amir A. Jamali, MD1; Hien Nguyen, MD2
1 Department of Orthopaedic Surgery, University of California at Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817. E-mail address for J. Meehan: John.Meehan@ucdmc.ucdavis.edu. E-mail address for A.A. Jamali: Amir.Jamali@ucdmc.ucdavis.edu
2 Division of Infectious Diseases, Department of Internal Medicine, University of California at Davis, 4150 V Street, Sacramento, CA 95817. E-mail address: Hien.Nguyen@ucdmc.ucdavis.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Oct 01;91(10):2480-2490. doi: 10.2106/JBJS.H.01219
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Prophylactic parenteral antibiotics have contributed to the present low rate of surgical site infections following hip and knee arthroplasty.

Over the past decade, there has been a change in the pattern of methicillin-resistant Staphylococcus aureus infections from hospital-acquired to community-acquired.

The findings of recent studies on screening programs to identify carriers of methicillin-resistant Staphylococcus aureus have been equivocal, with some studies showing that such programs reduce the rate of infections and others showing no effect on infection rates.

Hospitals with antibiogram data that reveal high Staphylococcus resistance should consider use of vancomycin as a prophylactic antibiotic.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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