[Treatment of orthopedic implant-associated infections].

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Abstract

[Indexed for MEDLINE] 19. Curr Drug Saf. 2023;18(1):116-120. doi: 10.2174/1574886317666220429081207. Antibiotic Prophylaxis for Orthopaedic Implant Removal: What Does the Evidence Say? Rather IIG(1), Shafiq N(1), Pandey AK(1), Bhandari RK(1), Malhotra S(1), Chouhan DK(2). Author information: (1)Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. (2)Department of Orthopaedic, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Orthopaedic implant removal is considered a sterile procedure, but the current literature suggests it is associated with around a 20% Surgical Site Infection (SSI) rate. The use of antibiotic prophylaxis is still ambiguous and contentious. Taking into consideration this issue we conducted a meta-analysis for the use of antibiotic prophylaxis in orthopaedic implant removal surgery. OBJECTIVES: To determine whether or not antibiotic prophylaxis benefits orthopaedic implant removal surgeries. METHODS: Electronic and printed sources were searched up to February 2021 for randomised controlled trials (RCTs) using antibiotic prophylaxis and a control group. Data from eligible studies were pooled for the following outcomes: overall, superficial, and deep surgical site infection (SSI). Pooled odds ratios with a 95% confidence interval (CI) were calculated using Mantel Haenszel fixed-effect model preferentially. RESULTS: Two studies, including 766 patients were included in this meta-analysis. Heterogeneity was not statistically significant between the studies. There was no significant difference in the incidence of overall SSI in cefazolin and normal saline (NS) groups (Pooled OR 0.79; 95% CI 0.53- 1.17). In subgroup analysis, antibiotic prophylaxis showed statistically significant improvement for deep SSI (Pooled OR 0.20; 95% CI 0.06-0.70). CONCLUSION: Overall incidence of SSI is not reduced after the administration of antibiotic prophylaxis one hour before removal of orthopaedic implants. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. DOI: 10.2174/1574886317666220429081207