Comparative multicenter trial of teicoplanin versus cefazolin for antimicrobial prophylaxis in prosthetic joint implant surgery

• Published in: European journal of clinical microbiology & infectious diseases 1999-03, Vol.18 (2), p.113-119
• Main Authors: PERITI, P, STRINGA, G, MINI, E
• Format: Article
• Language: English
• Subjects: Anesthesia; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Medical sciences; Pharmacology. Drug treatments; Prophylaxis
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s100960050238

A randomized multicenter study was carried out in 12 centers in Italy to compare administration of a single dose of teicoplanin (400mg i.v. bolus at time of anesthesia) versus that of five doses of cefazolin over a 24-h period (2g at induction of anesthesia and 1g every 6h postoperatively, i.v. bolus) as antimicrobial prophylaxis in patients undergoing hip or knee arthroplasty. Of 860 patients enrolled, 427 received teicoplanin and 433 cefazolin. A total of 846 patients (422 teicoplanin and 424 cefazolin) were evaluable for safety and 826 patients for efficacy. Six patients (1.5%) in the teicoplanin group and seven patients (1.7%) in the cefazolin group developed a surgical wound infection during their postoperative hospital stay: this difference was not significant. Proven or suspected infections involving other body systems occurred in 114 patients (57 in each group). Seven hundred ninety-two patients completed a 3-month evaluation and 738 patients a 12-month evaluation; the success rates in evaluable patients at these observation times were 99.2% and 99.7% for teicoplanin and 99.2% and 99.7% for cefazolin, respectively. Adverse events occurred in three (0.7%) teicoplanin patients and nine (2.1%) cefazolin patients (P=0.083). A single preoperative dose of teicoplanin ensures adequate surgical antisepsis, with results comparable to a standard multiple-dose regimen of cefazolin.[PUBLICATION ABSTRACT]