Prevention of Perioperative Infection

Diabetes Associated with Increased Surgical Site Infections in Spinal Arthrodesis

“…Regarding prophylactic antibiotics, from recent literature the choice seems clear: two studies recommend administering cefazolin as the perioperative antibiotic of choice [7,9]. However, the benefit of intraoperative redosing is unclear.…”

“…However, the benefit of intraoperative redosing is unclear. An intraoperative dose is recommended if the duration of the procedure exceeds one to two times the half-life of the antibiotic or if there is substantial blood loss [7,9,19]. However, in a prospective, controlled study evaluating blood loss on serum cefazolin level in spine fusion patients, the authors reported no difference between blood loss and cefazolin level [18].…”

Prospective study on antimicrobial prophylaxis in total hip arthroplasty

“…The Center for Medicare and Mediaid Services and CDC implemented the National Surgical Infection Prevention (SIP) project to reduce the morbidity and mortality rates associated with postoperative SSI by promoting the appropriate selection and timing of administration of prophylactic antimicrobials and recommended cefazolin and cefuroxime as antimicrobials for THA [8]. The American Academy of Orthopaedic Surgeons (AAOS) recommended cefazolin administration at 2-5-h intervals and its discontinuation within 24 h [9]. Concerning the cefazolin dose, the AAOS recommended 1 g as the standard and 2 g in patients weighing C80 kg [10].…”

Prevention of periprosthetic joint infection: Pre-, intra-, and post-operative strategies

“…Additionally, the impact of various risk factors is cumulative. 21,22 Therefore, it is imperative to identify the risk factors and address them pre-operatively to reduce the risk of PJI and other post-operative complications.…”

“…22 The optimum time for prophylactic antibiotic administration is within an hour prior to the surgery, in order to reach the minimal inhibitory concentration in the end organs during the operation. 44 In certain conditions such as prolonged surgical duration beyond the half-life of the antibiotic or when excessive blood loss occurs during the surgery, a second dose of antibiotic is required.…”