Faculty of Medicine, McGill University, Montréal, Que. (Mannarino); Division of Orthopedic Surgery, McGill University, Montréal, Que. (Montreuil, Tanzer, Hart).
Faculty of Medicine, McGill University, Montréal, Que. (Mannarino); Division of Orthopedic Surgery, McGill University, Montréal, Que. (Montreuil, Tanzer, Hart)
Can J Surg. 2023 Aug 8;66(4):E415-E421. doi: 10.1503/cjs.019621. Print 2023 Jul-Aug.
Periprosthetic joint infections (PJI) following joint arthroplasty are now the leading cause of reoperation and are associated with serious morbidity to the patient, often requiring several staged operations and a prolonged course of parenteral antibiotics. Prophylactic administration of intravenous antibiotics before skin incision is arguably the most important measure to prevent PJI; however, the dose effectiveness of cefazolin in target tissue is not well known. We aimed to identify parameters affecting local tissue concentration (LTC) of cefazolin.
We performed a literature search using the following keywords: "orthopaedics," "orthopedic," "arthroplasty" and "cefazolin." We included studies that measured LTC of cefazolin from samples obtained during either a total knee or total hip arthroplasty.
Of the 332 records screened, we included 10 studies that described LTC of cefazolin. The included studies evaluated dosing ( = 7), procedure type ( = 3), body mass index ( = 1) and tourniquet utilization ( = 1).
Few studies have measured LTC levels of antibiotics (or levels of cefazolin) to validate current recommendations for antibiotic prophylaxis in orthopedic surgery. With infection as the leading reason for early reoperation or revision surgery, the parameters affecting LTC during orthopedic procedures need to be further assessed.
关节置换术后的假体周围关节感染（PJI）现已成为再次手术的主要原因，并且会给患者带来严重的发病率，通常需要进行多次分期手术和长期的静脉注射抗生素治疗。在切开皮肤前预防性给予静脉注射抗生素可被认为是预防 PJI 的最重要措施；然而，头孢唑林在靶组织中的剂量有效性尚不清楚。我们旨在确定影响头孢唑林局部组织浓度（LTC）的参数。
我们使用以下关键词进行文献检索：“矫形”、“矫形”、“关节置换术”和“头孢唑林”。我们纳入了在全膝关节或全髋关节置换术中测量头孢唑林 LTC 的研究。
在筛选出的 332 份记录中，我们纳入了 10 项描述头孢唑林 LTC 的研究。这些研究评估了剂量（n = 7）、手术类型（n = 3）、体重指数（n = 1）和止血带使用（n = 1）。
很少有研究测量抗生素（或头孢唑林）的 LTC 水平，以验证骨科手术中抗生素预防的现有建议。由于感染是早期再次手术或翻修手术的主要原因，因此需要进一步评估影响骨科手术中 LTC 的参数。
