Antibiotic Prophylaxis for Hip Fracture Surgery: Three-Dose Cefuroxime versus Single-Dose Gentamicin and Amoxicillin. (December 2013)

• Record Type: Journal Article
• Authors: Jettoo, Prithee; Jeavons, Richard; Siddiqui, Bobby; O'Brien, Shaun
• Is Part Of: Journal of orthopaedic surgery. Volume 21:Number 3(2013)
• Page Start: 323
• Page End: 326
• Publication Date: 2013-12
• Subjects: antibiotic prophylaxis -- Clostidium difficile -- diarrhea -- hip fractures; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/230949901302100312
• Languages: English
• ISSNs: 1022-5536

Abstract

Purpose: To compare a 3-dose cefuroxime regimen with a single-dose gentamicin and amoxicillin regimen as antibiotic prophylaxis for hip hemiarthroplasty in terms of microbiological outcome. Methods: Records of 2 matched groups of patients who underwent hip hemiarthroplasty for femoral neck fractures were reviewed. 29 men and 84 women (mean age, 82 years) who received a 3-dose cefuroxime regimen in 2006 were compared with 23 men and 84 women (mean age, 83 years) who received a single-dose gentamicin and amoxicillin regimen in 2008. Patient demographics, antibiotics prescribed in the peri- and immediate postoperative period, microbiological evidence for Clostridium difficile 'infection', length of hospital stay, mortality, as well as biochemical and haematological findings were reviewed. Results: The 3-dose cefuroxime group was significantly higher in terms of the mean length of hospital stay (17 vs. 13 days, p=0.043) and the percentage of patients receiving postoperative antibiotics (88% vs. 68%, p<0.001) and having C difficile 'infection' (6% vs. 0%, p=0.016). If patients with C difficile 'infection' were excluded, there was no significant difference in the length of hospital stay. Conclusion: The single-dose gentamicin and amoxicillin regimen was associated with a lower C difficile 'infection' rate.