Antibiotic prophylaxis and incidence of infection following elbow arthroplasty : a nationwide study
(2025) In Acta Orthopaedica 96. p.278-282- Abstract
BACKGROUND AND PURPOSE: Periprosthetic joint infection (PJI) after elbow arthroplasty is a serious complication. Evidence of the best antibiotic prophylaxis for elbow arthroplasty is lacking. We aimed to investigate the regimens presently used in Sweden, incidence of PJI, and the bacteria most frequently found in elbow PJI.
METHODS: A questionnaire was sent out to all Swedish units performing elbow arthroplasty in 2019 asking about antibiotic prophylaxis routines. The Swedish Elbow Arthroplasty Register (SEAR) and national inpatient and outpatient registers (NPR) from the National Board of Health and Welfare were searched for procedures related to all primary total- or hemi-elbow arthroplasties performed during 2019-2021. Results... (More)
BACKGROUND AND PURPOSE: Periprosthetic joint infection (PJI) after elbow arthroplasty is a serious complication. Evidence of the best antibiotic prophylaxis for elbow arthroplasty is lacking. We aimed to investigate the regimens presently used in Sweden, incidence of PJI, and the bacteria most frequently found in elbow PJI.
METHODS: A questionnaire was sent out to all Swedish units performing elbow arthroplasty in 2019 asking about antibiotic prophylaxis routines. The Swedish Elbow Arthroplasty Register (SEAR) and national inpatient and outpatient registers (NPR) from the National Board of Health and Welfare were searched for procedures related to all primary total- or hemi-elbow arthroplasties performed during 2019-2021. Results of microbiological analyses of the suspected PJI cases were collected from the respective laboratory.
RESULTS: Most centers used only cloxacillin (44%) or cloxacillin together with benzylpenicillin (44%), as prophylaxis. 250 primary procedures were performed between 2019 and 2021, and the most used antibiotic prophylaxes were cloxacillin (61%) and cloxacillin with benzylpenicillin (23%). In the NPR, 20 patients (8%) with a diagnosis that could indicate PJI were found and 9 (3.6%) had a confirmed PJI. The most common bacteria were Staphylococcus epidermidis, Cutibacterium acnes, and Staphylococcus aureus.
CONCLUSION: Most centers used cloxacillin antibiotic prophylaxis for elbow arthroplasty. The incidence of PJI was 3.6%. The most frequent diagnosed pathogen was Staphylococcus epidermidis.
(Less)
- author
- Wänström, Johan E LU ; Dettmer, Anne ; Björnsson Hallgren, Hanna C ; Salomonsson, Björn ; Ljungquist, Oskar LU and Adolfsson, Lars E
- organization
- publishing date
- 2025-03-24
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Antibiotic Prophylaxis/methods, Incidence, Sweden/epidemiology, Arthroplasty, Replacement, Elbow/adverse effects, Prosthesis-Related Infections/prevention & control, Male, Female, Anti-Bacterial Agents/therapeutic use, Aged, Middle Aged, Registries, Surveys and Questionnaires, Elbow Joint/surgery, Cloxacillin/therapeutic use
- in
- Acta Orthopaedica
- volume
- 96
- pages
- 278 - 282
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:105001738392
- pmid:40134287
- ISSN
- 1745-3682
- DOI
- 10.2340/17453674.2025.43288
- language
- English
- LU publication?
- yes
- id
- bd0d8060-02cb-458e-9d9d-40ef97bc9708
- date added to LUP
- 2025-04-07 22:33:30
- date last changed
- 2025-07-13 06:56:12
@article{bd0d8060-02cb-458e-9d9d-40ef97bc9708,
abstract = {{<p>BACKGROUND AND PURPOSE: Periprosthetic joint infection (PJI) after elbow arthroplasty is a serious complication. Evidence of the best antibiotic prophylaxis for elbow arthroplasty is lacking. We aimed to investigate the regimens presently used in Sweden, incidence of PJI, and the bacteria most frequently found in elbow PJI.</p><p>METHODS: A questionnaire was sent out to all Swedish units performing elbow arthroplasty in 2019 asking about antibiotic prophylaxis routines. The Swedish Elbow Arthroplasty Register (SEAR) and national inpatient and outpatient registers (NPR) from the National Board of Health and Welfare were searched for procedures related to all primary total- or hemi-elbow arthroplasties performed during 2019-2021. Results of microbiological analyses of the suspected PJI cases were collected from the respective laboratory.</p><p>RESULTS: Most centers used only cloxacillin (44%) or cloxacillin together with benzylpenicillin (44%), as prophylaxis. 250 primary procedures were performed between 2019 and 2021, and the most used antibiotic prophylaxes were cloxacillin (61%) and cloxacillin with benzylpenicillin (23%). In the NPR, 20 patients (8%) with a diagnosis that could indicate PJI were found and 9 (3.6%) had a confirmed PJI. The most common bacteria were Staphylococcus epidermidis, Cutibacterium acnes, and Staphylococcus aureus.</p><p>CONCLUSION: Most centers used cloxacillin antibiotic prophylaxis for elbow arthroplasty. The incidence of PJI was 3.6%. The most frequent diagnosed pathogen was Staphylococcus epidermidis.</p>}},
author = {{Wänström, Johan E and Dettmer, Anne and Björnsson Hallgren, Hanna C and Salomonsson, Björn and Ljungquist, Oskar and Adolfsson, Lars E}},
issn = {{1745-3682}},
keywords = {{Humans; Antibiotic Prophylaxis/methods; Incidence; Sweden/epidemiology; Arthroplasty, Replacement, Elbow/adverse effects; Prosthesis-Related Infections/prevention & control; Male; Female; Anti-Bacterial Agents/therapeutic use; Aged; Middle Aged; Registries; Surveys and Questionnaires; Elbow Joint/surgery; Cloxacillin/therapeutic use}},
language = {{eng}},
month = {{03}},
pages = {{278--282}},
publisher = {{Taylor & Francis}},
series = {{Acta Orthopaedica}},
title = {{Antibiotic prophylaxis and incidence of infection following elbow arthroplasty : a nationwide study}},
url = {{http://dx.doi.org/10.2340/17453674.2025.43288}},
doi = {{10.2340/17453674.2025.43288}},
volume = {{96}},
year = {{2025}},
}