Addition of vancomycin not superior to placebo for preventing surgical site infections in arthroplasty<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b><\/p>\n
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WEDNESDAY, Oct. 18, 2023 (HealthDay News) — The addition of vancomycin to cefazolin prophylaxis is not superior to placebo for prevention of surgical site infections in patients undergoing arthroplasty, according to a study published in the Oct. 19 issue of the New England Journal of Medicine<\/em>.<\/p>\n Trisha N. Peel, M.B., B.S., Ph.D., from Monash University in Melbourne, Australia, and colleagues conducted a multicenter, superiority, placebo-controlled trial in which adult patients without known methicillin-resistant Staphylococcus aureus<\/em> (MRSA) colonization who were undergoing arthroplasty were randomly assigned to receive 1.5 g vancomycin or normal saline placebo in addition to cefazolin prophylaxis. The modified intention-to-treat analysis included 4,113 patients: 2,233 undergoing knee arthroplasty; 1,850 undergoing hip arthroplasty; and 30 undergoing shoulder arthroplasty.<\/p>\n The researchers found that surgical site infections occurred in 4.5 and 3.5 percent of patients in the vancomycin and placebo groups, respectively, among the modified intention-to-treat population (relative risk, 1.28; 95 percent confidence interval, 0.94 to 1.73; P = 0.11). Surgical site infection occurred in 5.7 and 3.7 percent of patients in the vancomycin and placebo groups, respectively, among those undergoing knee arthroplasty (relative risk, 1.52; 95 percent confidence interval, 1.04 to 2.23). For those undergoing hip arthroplasty, the corresponding proportions were 3.0 and 3.1 percent (relative risk, 0.98; 95 percent confidence interval, 0.59 to 1.63). Adverse events occurred in 1.7 percent of patients in both the vancomycin group and the placebo group.<\/p>\n “In this pragmatic, randomized trial involving adult patients undergoing arthroplasty who had a low prevalence of MRSA colonization, the addition of vancomycin was not superior to surgical antimicrobial prophylaxis with cefazolin,” the authors write.<\/strong><\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n