Role of prophylactic antibiotics in lesser toe fusion surgery: A prospective randomised controlled trial. Issue 1 (March 2017)

• Record Type: Journal Article
• Authors: Mangwani, J.; Gulati, A.; Benson, R.; Cichero, M.; Williamson, D.M.
• Is Part Of: Foot and ankle surgery. Volume 23:Issue 1(2017:Mar.)
• Page Start: 50
• Page End: 52
• Publication Date: 2017-03
• Subjects: K-wires -- Infection -- Antibiotics; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2016.02.004
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Prospective randomised controlled trial was performed to determine the incidence of local infection for lesser toe fusion surgery. 100 patients allocated into those who received prophylactic antibiotics (Group 1, n = 48) and those who did not (Group 2, n = 52). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. No clear evidence to support the use of prophylactic antibiotics in routine toe surgery requiring percutaneous K-wire insertion. Further multi-centre larger studies are required to investigate this subject. Abstract: Background: This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery. Methods: 100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4–6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n = 48) and those who did not (Group 2, n = 52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection. Results: The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients. Conclusion: The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.