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O2286 PROSPECTIVE COMPARATIVE STUDY OF FUSIDIC ACID, VANCOMYCIN AND CEFUROXIME, IN PROPHYLACTIC USE IN T.H.R. AND T.K.R. EARLY RESULTS



Abstract

Aims: Evaluation of postoperative infections in T.H.R. and T.K.R., after randomized prophylactic use of Fusidic acid, Vancomycin and Cefuroxime and assessment of their side effects. Methods: From December 2000 to September 2002, 182 patients (43 males and 139 females), were operated on T.H.R. and T.K.R. in Orthopaedic Department of University of Patras. Mean age was 65.8 years (range 33–90yrs.). The patients were categorized into three groups (A, B and C). In group A was administrated Fusidic acid 500mg and Cefuroxime 1.5gr preoperatively and 2 doses of Fusidic acid 500mg postoperatively. Group B received Vancomycin 1gr and Cefuroxime 1.5gr preoperatively and 2 doses of Vancomycin 1gr postoperatively. Group C received Cefuroxime 1.5gr preoperatively and 2 doses of Cefuroxime 750mg postoperatively. Blood tests were systematically performed preoperatively, and the þrst and þfth postoperative day. Mean follow up was 10,5 months (range 2–21 months). Results: One patient of group B developed deep wound infection. Superþcial infections developed 2 pt. (3.2%) of group A, 2 pt. (3.9%) of group B and 2 pt. (2.8%) of group C. Temperature over 38.3û C attributed to another infection site was observed in 6 pt. (9.8%) of group A, 3 pt. (5.8%) of group B and 5 pt. (7.1%) of group C, while temperature over 38.3û C with unknown origin was noted in 7,3,8 patients respectively. No side effect was recorded. Conclusions: The proper use of antibiotic prophylaxis according to pharmakoki-netic and pharmakodynamic properties combined with sterile surgical techniques prevents early deep wound infections in T.H.R. and T.K.R. The use of speciþc anti-staphylococcal agents is of no beneþt in antimicrobial prophylaxis for the above operations.

Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.