Teicoplanin vs cephamandole for antimicrobial prophylaxis in prosthetic joint implant surgery: (preliminary results)

Abstract

Infection following prosthetic joint implant jeopardizes the prosthesis and may lead to long-term locomotor disability. Interoperative antimicrobial prophylaxis can reduce the incidence of infectious complications. The comparative safety and efficacy of single-dose teicoplanin and four doses of cephamandole over a 24-hour period is currently being assessed in a single-blind, randomized concurrent study of patients who undergo first time hip or knee arthroplasty. Of 660 evaluated patients, 352 have received cephamandole and 308 teicoplanin. Two patients in each group had a surgical wound infection at 1 week after surgery. Reassessment 30 days postoperatively showed resolution of the infection in both of the teicoplanin patients and in one of the cephamandole patients. Proven or suspected infection involving other body systems occurred in 30 teicoplanin and 38 cephamandole patients at 1 week postoperatively and in 5 teicoplanin and 3 cephamandole patients 1 month after surgery. Adverse events occurred in 20 (5.1%) teicoplanin patients and 29 (7.1%) cephamandole patients. These preliminary results suggest that single-dose teicoplanin is a safe and effective prophylactic agent in prosthetic joint implant surgery.