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DOI: 10.1016/j.eimce.2018.12.010
Available online 16 June 2019
Dual prophylaxis with teicoplanin and cefazolin in the prevention of prosthetic joint infection
Profilaxis dual con teicoplanina añadida a cefazolina en la prevención de la infección de prótesis articular
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José María Barbero-Allendea,
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j_m_barbero@yahoo.es

Corresponding author.
, Marta García-Sánchezb, Eduardo Montero-Ruizc, Alfonso Vallés-Purroyd, Miguel Ángel Plasencia-Arribad, José Sanz-Morenoa
a Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
b Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
c Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain
d Servicio de Cirugía Ortopédica y Traumatológica, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Received 25 September 2018. Accepted 13 December 2018
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Tables (2)
Table 1. Comparison of patients in control group (cefazolin) and intervention group (cefazolin+teicoplanin).
Table 2. Comparison of PJI aetiology in control group (cefazolin) and intervention group (cefazolin+teicoplanin).
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Abstract
Introduction

There is a growing increase in prosthetic joint infection (PJI) incidence due to cephalosporin-resistant bacteria, used in surgical prophylaxis. The replacement of these with glycopeptides has not been shown to improve the results, but they have been shown to improve with their combination.

Methods

Comparative study of combination of teicoplanin and cefazolin before arthroplasty surgery against cefazolin alone from a previous control group.

Results

During the control period, there were 16 PJIs from 585 surgeries, while in the intervention group there were 6 from 579 (incidence 2.7% vs. 1.03%, RR 0.4, p=0.04). In control group, 11 of the infections were caused by Gram-positive bacteria vs. 4 in the intervention group (1.8% vs. 0.7%, p=0.08).

Conclusions

The addition of teicoplanin to cefazolin in the prophylaxis of arthroplasty surgery was associated with a reduction in the incidence of PJI, thanks to a decrease in infections caused by Gram-positive bacteria.

Keywords:
Prosthesis-related infections
Antibiotic prophylaxis
Teicoplanin
Resumen
Introducción

Existe un creciente aumento de las infecciones de prótesis articular (IPA) por bacterias resistentes a las cefalosporinas utilizadas en la profilaxis quirúrgica. La sustitución de estas por glucopéptidos no ha demostrado mejorar los resultados pero sí su asociación.

Métodos

Estudio comparativo de la asociación de teicoplanina y cefazolina antes de la cirugía de artroplastia frente a cefazolina sola de un grupo control previo.

Resultados

En el periodo control hubo 16 IPA de 585 cirugías, mientras que en el grupo de intervención fueron 6 de 579 (incidencia 2,7% vs. 1,03%; RR 0,4, p=0,04). En el grupo control, 11 de las infecciones fueron causadas por bacterias grampositivas frente a 4 en el de intervención (1,8% vs. 0,7%, p=0,08).

Conclusiones

La adición de teicoplanina a cefazolina en la profilaxis de la cirugía de artroplastia se asoció a una reducción de la incidencia de IPA, a expensas de un descenso de las causadas por grampositivos.

Palabras clave:
Infecciones relacionadas con prótesis
Profilaxis antibiótica
Teicoplanina

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