Prophylactic antibiotics in hip and knee arthroplasty

▶ Prophylactic parenteral antibiotics have contributed to the present low rate of surgical site infections following hip and knee arthroplasty. ▶ Over the past decade, there has been a change in the pattern of methicillin-resistant Staphylococcus aureus infections from hospital-acquired to community-acquired. ▶ The findings of recent studies on screening programs to identify carriers of methicillin-resistant Staphylococcus aureus have been equivocal, with some studies showing that such programs reduce the rate of infections and others showing no effect on infection rates. ▶ Hospitals with antibiogramdata that reveal high Staphylococcus resistance should consider use of vancomycin as a prophylactic antibiotic.