Antibiotic prophylaxis in primary and revision shoulder replacement: a systematic review.
Adolescent
Adult
Aged
Anti-Bacterial Agents
/ administration & dosage
Antibiotic Prophylaxis
/ methods
Arthroplasty, Replacement, Shoulder
/ adverse effects
Child
Female
Follow-Up Studies
Gram-Positive Bacterial Infections
/ etiology
Humans
Male
Middle Aged
Propionibacterium acnes
/ isolation & purification
Prosthesis-Related Infections
/ etiology
Sex Factors
Shoulder Joint
/ microbiology
Treatment Outcome
Young Adult
Antibiotic prophylaxis
Infection
Propionibacterium acnes
Shoulder arthroplasty
Total shoulder replacement
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
11 May 2020
11 May 2020
Historique:
received:
09
04
2020
accepted:
06
05
2020
entrez:
13
5
2020
pubmed:
13
5
2020
medline:
2
2
2021
Statut:
epublish
Résumé
One of the most common bacteria responsible for most Periprosthetic joint infection (PJI) is Propionibacterium acnes. Even though the rate of infections in patients undergoing total shoulder arthroplasty is increasing, effective diagnostic tests and the precautions taken during the surgery are not yet adequate. This systematic review aims to evaluate the effectiveness of antimicrobial prophylaxis in PJI in shoulder replacement and to provide health workers with the best approach to the use of antimicrobial agents based on currently available clinical evidence. a systematic review of the literature was carried out in accordance with the PRISMA Statement. Studies concerning the effectiveness of antimicrobial prophylaxis in the prevention of PJI in patients undergoing shoulder replacement were included. Seven studies were included in the final analysis because they were considered valid. A total of 3272 patients underwent a surgical procedure, most of which were males. The male population has a greater presence of hair, therefore a greater risk of P. acnes. in surface cultures. Patients were assessed at an average follow-up period of 20 months ranging from 9 weeks to 53 months. The optimal perioperative antimicrobial regimen is controversial. The clinical guidelines recommend the use of only one antibiotic as prophylaxis but considering the increase in the rates of antibiotic-resistant infections, the question arises whether antibiotic prophylaxis should be extended for adequate coverage. Shoulder arthroplasty performed on the male population must be carefully checked after surgery for the possible presence of P. Acnes.
Sections du résumé
BACKGROUND
BACKGROUND
One of the most common bacteria responsible for most Periprosthetic joint infection (PJI) is Propionibacterium acnes. Even though the rate of infections in patients undergoing total shoulder arthroplasty is increasing, effective diagnostic tests and the precautions taken during the surgery are not yet adequate. This systematic review aims to evaluate the effectiveness of antimicrobial prophylaxis in PJI in shoulder replacement and to provide health workers with the best approach to the use of antimicrobial agents based on currently available clinical evidence.
METHODS
METHODS
a systematic review of the literature was carried out in accordance with the PRISMA Statement. Studies concerning the effectiveness of antimicrobial prophylaxis in the prevention of PJI in patients undergoing shoulder replacement were included.
RESULTS
RESULTS
Seven studies were included in the final analysis because they were considered valid. A total of 3272 patients underwent a surgical procedure, most of which were males. The male population has a greater presence of hair, therefore a greater risk of P. acnes. in surface cultures. Patients were assessed at an average follow-up period of 20 months ranging from 9 weeks to 53 months.
CONCLUSION
CONCLUSIONS
The optimal perioperative antimicrobial regimen is controversial. The clinical guidelines recommend the use of only one antibiotic as prophylaxis but considering the increase in the rates of antibiotic-resistant infections, the question arises whether antibiotic prophylaxis should be extended for adequate coverage. Shoulder arthroplasty performed on the male population must be carefully checked after surgery for the possible presence of P. Acnes.
Identifiants
pubmed: 32393217
doi: 10.1186/s12891-020-03332-z
pii: 10.1186/s12891-020-03332-z
pmc: PMC7216509
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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