Trends in Extended Oral Antibiotic Prophylaxis Utilization Following Primary and Revision Total Hip Arthroplasty From 2010 to 2022.

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  • Additional Information
    • Source:
      Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE
    • Publication Information:
      Publication: New Brunswick, NJ : Taylor and Francis
      Original Publication: [New York, NY : Churchill Livingstone, c1986-
    • Subject Terms:
      Arthroplasty, Replacement, Hip*/trends ; Arthroplasty, Replacement, Hip*/adverse effects ; Antibiotic Prophylaxis*/trends ; Antibiotic Prophylaxis*/statistics & numerical data ; Prosthesis-Related Infections*/prevention & control ; Reoperation*/statistics & numerical data ; Reoperation*/trends ; Anti-Bacterial Agents*/administration & dosage ; Anti-Bacterial Agents*/therapeutic use; Humans ; Male ; Female ; Middle Aged ; Aged ; Administration, Oral ; Practice Patterns, Physicians'/trends ; Practice Patterns, Physicians'/statistics & numerical data ; Adult ; Retrospective Studies
    • Abstract:
      Background: In patients considered high-risk for infection, extended oral antibiotic (EOA) prophylaxis has been demonstrated to reduce rates of prosthetic joint infection following total hip arthroplasty (THA). Although national guidelines regarding their use have not yet been created, the increase in literature surrounding EOA prophylaxis suggests a potential change in practice patterns. The purpose of this study was to investigate the trends in utilization of EOA prophylaxis following THA from 2010 to 2022 and identify prescription patterns.
      Methods: A total of 646,059 primary THA and 51,879 aseptic revision THA patients were included in this study. Patients who underwent primary or aseptic revision THA between 2010 and 2022 were identified in a national administrative claims database. Rates and duration of EOA prescriptions were calculated. A secondary analysis examined rates of utilization across demographics, including patients considered high risk for infection.
      Results: From 2010 to 2022, utilization of EOA increased by 366% and 298% following primary and revision THA, respectively. Of patients prescribed postoperative antibiotics, 30% and 59% were prescribed antibiotics for more than 7 days following primary and revision THA, respectively. Rates of utilization were similar between high-risk individuals and the general population.
      Conclusions: Rates of utilization of EOA prophylaxis after THA have increased significantly since 2010. As current trends demonstrate a wide variation in prescription patterns, including in length of antibiotic duration and in patient population prescribed, guidelines surrounding the use of EOA prophylaxis after THA are necessary to promote antibiotic stewardship while preventing rates of periprosthetic joint infection.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: extended oral antibiotic; periprosthetic joint infection; primary total hip arthroplasty; prophylaxis; revision total hip arthroplasty
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20240114 Date Completed: 20240722 Latest Revision: 20240722
    • Publication Date:
      20240723
    • Accession Number:
      10.1016/j.arth.2024.01.016
    • Accession Number:
      38220026