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Post-Operative Prophylactic Antibiotics for Patients Undergoing Hip Fracture Repair Surgery or Hip Arthroplasty: A Review of Clinical Effectiveness and Guidelines

Last updated: November 20, 2019
Project Number: RC1205-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of post-operative prophylactic antibiotics for patients undergoing hip fracture repair surgery or hip arthroplasty?
  2. What are the evidence-based guidelines regarding the use of post-operative prophylactic antibiotics for patients undergoing hip fracture repair surgery or hip arthroplasty?

Key Message

Two systematic reviews, with a limited number of studies that were generally of low or unclear quality, suggested that there was no statistically significant difference in infection rates with or without post-operative antibiotic prophylaxis in patients undergoing surgery for hip fracture repair or hip arthroplasty.One non-randomized retrospective study suggested that for patients who were undergoing total hip arthroplasty and at high risk of peri-prosthetic joint infection, extended post-operative antibiotic prophylaxis resulted in a statistically significantly lower infection rate compared with no extended post-operative antibiotic prophylaxis. Findings need to be interpreted with caution, considering the limitations (such as few identified studies specific to hip fracture repair or hip arthroplasty, and studies of low quality). No evidence-based guideline for post-operative antibiotic prophylaxis for patients undergoing surgery for hip fracture repair or hip arthroplasty was identified.