A study published online in the journal PLoS Medicine finds no association between use of combination antimicrobial prophylaxis and a reduction in incidence of surgical site infection (SSI) for joint arthroplasty procedures. 

The research team reviewed data on 70,101 surgeries from a multicenter, U.S. Veterans Affairs cohort of patients who underwent cardiac, orthopaedic joint arthroplasty, vascular, colorectal, and hysterectomy procedures. Overall, 52,504 patients underwent antimicrobial prophylaxis with beta-lactam only, 5,089 with vancomycin only, and 12,508 received combination prophylaxis with both beta-lactam and vancomycin, and there were 2,466 SSIs. After adjustment for SSI risk, the research team found that, compared to single-agent prophylaxis, combination prophylaxis was associated with a lower incidence of SSI only for cardiac surgery patients. For all other types of surgery—including joint arthroplasty—they found no link between receipt of combination prophylaxis and reduced likelihood of SSI. Learn more...