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Patterns and Predictors of Outpatient Antibiotic Dispensation Following Total Hip and Knee Arthroplasty.
Naufal, Elise; Shadbolt, Cade; Elsiwy, Yassin; Thuraisingam, Sharmala; Poy Lorenzo, Yves S; Darby, Jonathan; Babazadeh, Sina; Choong, Peter F M; Dowsey, Michelle M; Stevens, Jarrad M.
Affiliation
  • Naufal E; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Shadbolt C; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Elsiwy Y; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia.
  • Thuraisingam S; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Poy Lorenzo YS; Pharmacy Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; University of Melbourne, Melbourne Medical School, Department of Medicine, Fitzroy, Victoria, Australia.
  • Darby J; Department of Infectious Diseases, St Vincent's Hospital Melbourne, Vic, Australia.
  • Babazadeh S; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Choong PFM; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Dowsey MM; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Department of Orthopaedics, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  • Stevens JM; Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia; University of Melbourne, Melbourne Medical School, Department of Medicine, Fitzroy, Victoria, Australia; Victorian Bone & Joint Specia
J Arthroplasty ; 37(6): 1040-1047.e1, 2022 06.
Article in En | MEDLINE | ID: mdl-35176455
BACKGROUND: This study aimed to evaluate the month-to-month prevalence of antibiotic dispensation in the 12 months before and after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and to identify factors associated with antibiotic dispensation in the month immediately following the surgical procedure. METHODS: In total, 4,115 THAs and TKAs performed between April 2013 and June 2019 from a state-wide arthroplasty referral center were analyzed. A cross-sectional study used data from an institutional arthroplasty registry, which was linked probabilistically to administrative dispensing data from the Australian Pharmaceutical Benefits Scheme. Multivariable logistic regression was carried out to identify patient and surgical risk factors for oral antibiotic dispensation. RESULTS: Oral antibiotics were dispensed in 18.3% of patients following primary TKA and 12.0% of patients following THA in the 30 days following discharge. During the year after discharge, 66.7% of TKA patients and 58.2% of THA patients were dispensed an antibiotic at some point. Patients with poor preoperative health status were more likely to have antibiotics dispensed in the month following THA or TKA. Older age, undergoing TKA rather than THA, obesity, inflammatory arthritis, and experiencing an in-hospital wound-related or other infectious complications were associated with increased antibiotic dispensation in the 30 days following discharge. CONCLUSION: A high rate of antibiotic dispensation in the 30 days following THA and TKA has been observed. Although resource constraints may limit routine wound review for all patients by a surgeon, a select cohort may benefit from timely specialist review postoperatively. Several risk factors identified in this study may aid in identifying appropriate candidates for such changes to follow-up care.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee Type of study: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspects: Patient_preference Limits: Humans Country/Region as subject: Oceania Language: En Journal: J Arthroplasty Journal subject: ORTOPEDIA Year: 2022 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee Type of study: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspects: Patient_preference Limits: Humans Country/Region as subject: Oceania Language: En Journal: J Arthroplasty Journal subject: ORTOPEDIA Year: 2022 Document type: Article Affiliation country: Country of publication: