[Prophylactic antibiotic therapy with cefamandole in total hip surgery replacement using Charnley's tent. A randomized study]

Abstract

A randomized study of one-day prophylactic antibiotic therapy in total hip arthroplasty was performed in 93 procedures in 84 patients. All patients were operated by the same surgeons with use of a clean air system. They were divided into two groups: K- without antibiotic, and K+ with intravenous cefamandole, 1.5 g before incision followed by 1.5 g every four hours up to the 24th postoperative hour. Clinical follow up by the surgeons included four examinations within the first year. There was no significant difference in age, repartition of sexes or acquired physical defects between the two groups. Major deep infections requiring revision surgery occurred early in one case in K+ and early in four cases and late in one in K6. Nine patients had bilateral hip replacement. Only one infection was observed, in the only patient who did not receive cefamandole for either procedure. Physical disability had no influence on infection. Microbial organisms isolated from deep infection foci were not consistently identical with pathogens previously identified in wound drainage fluid. Staphylococcus aureus was responsible for 4 of 6 deep infections. One-day prophylactic antibiotic therapy by cefamandole decreases the incidence of deep infection at the surgical site in total hip arthroplasty with use of a clean air system.