Preoperative antibiotic prophylaxis in prosthetic joint infections: not a concern for intraoperative cultures

Daniel Pérez-Prieto, María E. Portillo, Lluís Puig-Verdié, Albert Alier, Carlo Gamba, Pau Guirro, Santos Martínez-Díaz, Juan P. Horcajada, Andrej Trampuz, Joan C. Monllau

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29 Citations (Scopus)


© 2016 Elsevier Inc. Background Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. Material and Methods An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital. Patients were prospectively randomized into two groups. The control group received the classical preoperative antibiotic prophylaxis. The study group did not receive prophylaxis prior to surgery. Results There were 14 patients in each group. They correspond to 13 total hip arthroplasty infections, 12 total knee arthroplasty infections and 3 reverse shoulder prosthesis infections. There were 10 patients in the study group and 10 patients in the control group with at least one positive microbiological criterion (P > 0.05). There were 4 patients in each group with a culture negative PJI (P > 0.05). Conclusions Preoperative antibiotic prophylaxis does not affect intraoperative cultures in suspected or confirmed PJI. Therefore it is essential to deliver antibiotic prophylaxis in any patient in which a prosthesis is to be implanted in order to protect the prosthesis from infection.
Original languageEnglish
Pages (from-to)442-445
JournalDiagnostic Microbiology and Infectious Disease
Issue number4
Publication statusPublished - 1 Dec 2016


  • Antibiotic prophylaxis
  • Biofilm
  • Prosthetic joint infection
  • Sonication


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