Antibiotic prophylaxis in orthopedic surgery; has the time to reconsider the current practice arrived?

Introduction: The current practice of antibiotic prophylaxis in orthopedic surgery has existed almost 50 years yet little changes have been made. The incidence of methicillin resistant Staphylococci and multi-drug resistant Gram-negative bacteria is growing. Methods: We studied the positive cultures after primary hip and knee joint replacement and trauma surgery at our department.Results: Our investigation substantiates the current reports of an increase in oxacillin resistance of Staphylococci and an increase in incidence of Gram-negative bacteria. Conclusions: The standard use of cephalosporins for prophylaxis does not provide the necessary protection that it used to. We suggest that the recommendations and practice of antibiotic prophylaxis should be reconsidered.