Abstract
The aim of the present work was to survey the situation of healthcare regarding the
use of prophylactic and empirical antibiotics in primary arthroplasty and treatment
of periprosthetic
joint infections (PJI). For this purpose, a survey was conducted at German university
and occupational accident hospitals. Survey data was compared to previously published
data on the
antimicrobial regimes of PJI (n=81) patients (n=81) treated in our department between
2017 and 2020. A homogeneous picture emerged for the prophylactic administration of
antibiotics in the
context of primary arthroplasty. In 93.2% (elective) and 88.6% (fracture treatment)
of the hospitals, first or second generation cephalosporins were administered perioperatively
for
infection prophylaxis in primary hip arthroplasty. The empirical antibiotic treatment
of PJIs showed a clearly inhomogeneous therapeutic picture. Monotherapy with an aminopenicillin
plus a
beta-lactamase inhibitor is used most frequently (38.7%); first and second generation
cephalosporins are used second most frequently as monotherapy (18.2%). In light of
the global problem of
antibiotic multi-resistance, clinical use of antibiotics has to be reasonable and
effective. The present results highlight the further need to improve awareness and
following existing
guidelines in the administration of empirical antibiotic therapy in PJI.
Keywords antibiotic prophylaxis - empirical antibiotic therapy - periprosthetic joint infections
- arthroplasty - joint replacement
