Antibiotic Prophylaxis for Hip Fracture Surgery: Three-Dose Cefuroxime versus Single-Dose Gentamicin and Amoxicillin

Jettoo, Prithee; Jeavons, Richard; Siddiqui, Bobby; O’Brien, Shaun

doi:10.1177/230949901302100312

Cited by 6 publications

(9 citation statements)

References 10 publications

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“…Thirty‐six studies were included in the final synthesis: one thesis and 35 journal articles . The 36 studies included 11 randomized controlled studies (two crossover designs), 18 cohort studies, one retrospective survey, three pharmacokinetic and three quasiexperimental studies.…”

Section: Resultsmentioning

confidence: 99%

“…Reported adverse events are summarized in Table . Twenty‐three , of the 36 included studies, reported adverse events in the gentamicin arm of their study although not all adverse events were related to gentamicin. Pons et al .…”

Section: Resultsmentioning

confidence: 99%

“…A significant number of studies have been published in the last 3 years, almost as many as in the previous 50 years. The majority of these recent studies are a form of cohort study, without randomization.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of these recent studies are a form of cohort study, without randomization. Many of the studies reviewed a change in local antibiotic policies, particularly within orthopaedic surgery . Authors compared a cephalosporin with gentamicin plus another antibiotic, frequently flucloxacillin.…”

Section: Resultsmentioning

confidence: 99%

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Adverse effects of a single dose of gentamicin in adults: a systematic review

Hayward¹,

Harding²,

Molloy³

et al. 2017

Brit J Clinical Pharma

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RESULTSIn total, 15 522 records were identified. After removal of duplicates, screening of title/abstracts for relevance and independent selection of full texts by two reviewers, 36 studies were included. Across all the included studies, 24 107 participants received a single one-off dose of gentamicin (doses ranged from 1 mg kg -1 to 480 mg per dose). Acute kidney injury was described in 2520 participants receiving gentamicin. The large majority of cases were reversible. There were no cases of ototoxicity reported in patients receiving gentamicin. A meta-analysis was not performed due to study heterogeneity. CONCLUSIONSA significant number of patients saw a transient rise in creatinine after a single dose of gentamicin at doses up to 480 mg. Persistent renal impairment and other adverse events were relatively rare.British Journal of Clinical Pharmacology Br J Clin Pharmacol (2018) 84 223-238 223

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Adverse effects of a single dose of gentamicin in adults: a systematic review

Hayward¹,

Harding²,

Molloy³

et al. 2017

Brit J Clinical Pharma

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“…difficile infection, the magnitude of reduction ranged from two to six fold. [10–13] Three of these studies were designed to demonstrate the effectiveness of new antibiotic policies recommending narrower-spectrum antibiotics and lower doses [11–13], the most restrictive of which allowed for a single-dose of gentamicin and amoxicillin antibiotic prophylaxis regimen for hip hemiarthroplasty in surgical patients [13]. …”

Section: Introductionmentioning

confidence: 99%

Antibiotic prophylaxis for surgical site infections as a risk factor for infection with Clostridium difficile

et al. 2017

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ObjectiveWe aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile.DesignWe conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013.SettingLarge urban community hospital.PatientsCases and controls were patients age 18+ years who underwent an eligible surgery (i.e., colorectal, neurosurgery, vascular/cardiac/thoracic, hysterectomy, abdominal/pelvic and orthopedic surgical procedures) within six months prior to infection diagnosis. Cases were diagnosed with C. difficile infection while controls were not.MethodsThe primary exposure was receiving (vs. not receiving) the recommended prophylactic antibiotic regimen, based on type and duration. Potential confounders included age, sex, length of hospital stay, comorbidities, type of surgery, and prior antibiotic use. Crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression.ResultsWe enrolled 68 cases and 220 controls. The adjusted OR among surgical patients between developing C. difficile infection and not receiving the recommended prophylactic antibiotic regimen (usually receiving antimicrobial prophylaxis for more than 24 hours) was 6.7 (95% CI: 2.9–15.5). Independent risk factors for developing C. difficile infection included having severe comorbidities, receiving antibiotics within the previous 6 months, and undergoing orthopedic surgery.ConclusionsAdherence to the recommended prophylactic antibiotics among surgical patients likely reduces the probability of being case of C. difficile. Antibiotic stewardship should be a priority in strategies to decrease the morbidity, mortality, and costs associated with C. difficile infection.

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