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Can too Much Antibiotic Prophylaxis in Arthroplasty Surgery be Harmful? Results of a Series of Cases Study

José María Barbero, Eduardo Montero, Rosa Agudo, Marta García, Ángela Rebollar, Luis Gete, Ana Culebras and Joaquín López

Background: Preoperative antibiotic prophylaxis has been shown to decrease the incidence of surgical wound infection. Prosthetic joint infection (PJI) is a type of surgical wound infection with serious consequences.
Objective: The purpose of this study is to evaluate whether expanding the antibiotic prophylaxis with repeated doses in the postoperative period may lead to an increase in the incidence of PJI.
Patients and methods: We retrospectively analyzed 556 patients undergoing hip or knee primary arthroplasty in our hospital between January 1, 2009 and December 31, 2010. All the patients received a preoperative dose of an antibiotic and 164 patients also received at least one additional dose after surgery.
Results:
There were 16 PJI (incidence of 2.9%). PJI occurred in 7/94 patients with repeated doses of antibiotics after surgery (7.4%), compared to 9/462 (1.9%) in patients who only received the preoperative dose (odds ratio [OR] 3.1, confidence interval [CI] 95% 1.1 to 9.4, p=0.04).
Conclusions: In our study, the patients who received antibiotics after surgery were at greater risk of developing PJI.