Cefamandole and isoxazolyl penicillins in antibiotic prophylaxis of patients undergoing total hip or knee-joint arthroplasty

In a prospective comparative clinical efficacy and safety study, 58 patients undergoing total hip or knee arthroplasty were randomly allocated to two groups; one received 29 cefamandole intravenously before operation and then 1 g every 6 h parenterally for 3 days and the other received 29 cloxacilli...

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Bibliographic Details
Published in:Archives of Orthopaedic and Traumatic Surgery 1988-01, Vol.107 (4), p.228-230
Main Authors: VAINIONPAA, S, WILPPULA, E, LALLA, M, RENKONEN, O.-V, ROKKANEN, P
Format: Article
Language:English
Subjects:
Aged
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Blood Sedimentation
C-Reactive Protein - analysis
Cefamandole - adverse effects
Cefamandole - pharmacokinetics
Cefamandole - therapeutic use
Cloxacillin - adverse effects
Cloxacillin - pharmacokinetics
Cloxacillin - therapeutic use
Dicloxacillin - adverse effects
Dicloxacillin - pharmacokinetics
Dicloxacillin - therapeutic use
Female
Hip Joint - surgery
Hip Prosthesis
Humans
Knee Joint - surgery
Knee Prosthesis
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Premedication
Prospective Studies
Random Allocation
Synovial Fluid - analysis
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Summary:In a prospective comparative clinical efficacy and safety study, 58 patients undergoing total hip or knee arthroplasty were randomly allocated to two groups; one received 29 cefamandole intravenously before operation and then 1 g every 6 h parenterally for 3 days and the other received 29 cloxacillin i.v. every 8 h for 1 day and 29 dicloxacillin perorally every 8 h for 2 days. Concentrations of cefamandole and cloxacillin were measured in the serum of all patients and in the synovial fluid of 28 patients. The serum C-reactive protein (CRP) level was measured in 16 randomly allocated patients preoperatively and daily for 8 days. In serum the concentrations of cefamandole and cloxacillin were high. The great variation in cloxacillin concentration can be due in part to its strong affinity for blood proteins. Cefamandole entered the synovial fluid of the knee joint at high concentrations in 5-15 min; similar concentrations of cloxacillin were measured after 16-30 min. Thus, cefamandole seems to be more recommendable as antibiotic prophylaxis in total hip and knee replacements. The CRP level decreased to below 60 mg/l in all 16 patients on the 6th postoperative day.
ISSN:0344-8444
1434-3916
DOI:10.1007/BF00449674