Antibiotic prophylaxis in orthopedic surgery; has the time to reconsider the current practice arrived?

Introduction: The current practice of antibiotic prophylaxis in orthopedic surgery has existed almost 50 years yet little changes have been made. The incidence of methicillin resistant Staphylococci and multi-drug resistant Gram-negative bacteria is growing. Methods: We studied the positive cultures after primary hip and knee joint replacement and trauma surgery at our department. Results: Our investigation substantiates the current reports of an increase in oxacillin resistance of Staphylococci and an increase in incidence of Gram-negative bacteria. Conclusions: The standard use of cephalosporins for prophylaxis does not provide the necessary protection that it used to. We suggest that the recommendations and practice of antibiotic prophylaxis should be reconsidered. Level of Evidence: Level III – retrospective cohort study.