Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Oct 12:18:52-56.
doi: 10.1016/j.artd.2022.08.016. eCollection 2022 Dec.

Cefadroxil-Induced Clostridium difficile Infection Following Total Knee Arthroplasty

Nathan Angerett  1   2   3 , Christopher Ferguson  1 , Michael Kahan  1   3 , Devin Fitz  1 , Richard Hallock  1   2
Affiliations
Case Reports

Cefadroxil-Induced Clostridium difficile Infection Following Total Knee Arthroplasty

Nathan Angerett et al. Arthroplast Today. .

Abstract

Perioperative infection prophylaxis is a fundamental element of total knee arthroplasty (TKA). There has been a recent trend toward the use of extended postoperative oral antibiotics in high-risk patients. We describe a case report of a patient who underwent a primary TKA and subsequently developed Clostridium difficile colitis after an extended course of postoperative prophylactic oral cefadroxil. Following the C. difficile infection, the patient eventually developed bacteremia and a multidrug-resistant Escherichia coli prosthetic joint infection which required multiple debridements. Extended use of postoperative prophylactic oral cefadroxil may increase the risk of C. difficile-associated diarrhea. Additionally, our case suggests that C. difficile infection may subsequently increase the risk of bacteremia which could lead to prosthetic joint infection. More evidence is required to further define this risk.

Keywords: C. difficile; Case report; Cefadroxil; Extended postoperative antibiotics; Prosthetic joint infection; Total knee arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preoperative plain radiographs (standing posteroanterior and lateral) demonstrating primary, severe tricompartmental osteoarthritis of the left knee.
Figure 2
Figure 2
Postoperative plain radiographs (standing posteroanterior and lateral) demonstrating left total knee arthroplasty.
Figure 3
Figure 3
Postoperative plain radiographs demonstrating left knee static antibiotic spacer using a carbon fiber external fixator rod.
See this image and copyright information in PMC

References

    1. Yates A.J. Postoperative prophylactic antibiotics in total joint arthroplasty. Arthroplasty Today. 2018;4:130–131. - PMC - PubMed
    1. Kurtz S.M., Lau E., Watson H., Schmier J.K., Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012;27(8 SUPPL):61–65.e1. - PubMed
    1. Shahi A., Parvizi J. Prevention of periprosthetic joint infection. Arch Bone Joint Surg. 2015;3:72–81. - PMC - PubMed
    1. Global guidelines for the prevention of surgical site infection. 2nd ed. World Health Organization; Geneva: 2018. - PubMed
    1. Parvizi J., Gehrke T., Chen A. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013;95-B:1450–1452. - PubMed

Publication types

LinkOut - more resources