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Review
. 2023 Aug 1;105-B(8):850-856.
doi: 10.1302/0301-620X.105B8.BJJ-2022-1418.R1.

Prophylactic antibiotics for massive endoprostheses in orthopaedic oncology

Tariq Azamgarhi  1 , Simon Warren  2 , Sarah Fouch  3 , Joseph F Standing  4 , Craig Gerrand  5
Affiliations
Review

Prophylactic antibiotics for massive endoprostheses in orthopaedic oncology

Tariq Azamgarhi et al. Bone Joint J. .

Abstract

The recently published Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY) trial found no benefit in extending antibiotic prophylaxis from 24 hours to five days after endoprosthetic reconstruction for lower limb bone tumours. PARITY is the first randomized controlled trial in orthopaedic oncology and is a huge step forward in understanding antibiotic prophylaxis. However, significant gaps remain, including questions around antibiotic choice, particularly in the UK, where cephalosporins are avoided due to concerns of Clostridioides difficile infection. We present a review of the evidence for antibiotic choice, dosing, and timing, and a brief description of PARITY, its implication for practice, and the remaining gaps in our understanding.

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Conflict of interest statement

The authors declare no competing interests. J. F. Standing reports research grants from the Medical Research Council (MRC), the Wellcome Trust, National Institute for Health and Care Research (NIHR), and Great Ormond Street Hospital (GOSH), consulting fees paid to their institution from Adrenomed, Proveca, and ClinSearch, and participation on a data safety monitoring board or advisory board for GSK, all of which are unrelated to this study. C. Gerrand reports institutional funding from Stryker, which is unrelated to this study.

References

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