[Prevention of infection in elective orthopedic interventions with special reference to alloplastic joint replacement].

Based on a study of 105 patients and a comprehensive literature review we recommend a prophylactic regimen for orthopaedic procedures which is easily adaptable to the needs of individual clinics. The regimen is especially designed for joint replacements and includes basically the following four points: 1. parenteral prophylaxis with cefazolin 1 g every 6 hours for 24 hours; the first dose is given between 10 and 30 minutes before surgery (for knee-replacement the initial dose is 2 g); 2. use of bone cement impregnated with antibiotics, e.g. Palacos-Gentamycin-cement; 3. when possible the operation should be performed in a theater equipped with "ultra-clean-air" laminar air-flow and the surgeon should wear "whole-body-exhaust" suits or suits made of "Fabric 450"; 4. antibiotic selection as outlined in points one and two must be adjusted over time based on ongoing monitoring of antimicrobial resistance in the individual clinic.