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dc.contributor.authorPawloy, Karola
dc.contributor.authorFenstad, Anne Marie
dc.contributor.authorLeta, Tesfaye Hordofa
dc.contributor.authorHallan, Geir
dc.contributor.authorGjertsen, Jan-Erik
dc.contributor.authorDale, Håvard
dc.contributor.authorLie, Stein Atle
dc.contributor.authorFurnes, Ove Nord
dc.date.accessioned2023-10-06T12:33:04Z
dc.date.available2023-10-06T12:33:04Z
dc.date.created2023-09-29T14:38:35Z
dc.date.issued2023
dc.identifier.issn1745-3674
dc.identifier.urihttps://hdl.handle.net/11250/3094976
dc.description.abstractBackground and purpose: Systemic antibiotic prophylaxis with clindamycin, which is often used in penicillin- or cephalosporin-allergic patients’, has been associated with a higher risk of surgical revision for deep prosthetic joint infection (PJI) than cloxacillin in primary total knee replacement (TKR). We aimed to investigate whether clindamycin increases the risk of surgical revisions due to PJI compared with cephalosporins in primary cemented TKR. Patients and methods: Data from 59,081 TKRs in the Norwegian Arthroplasty Register (NAR) 2005–2020 was included. 2,655 (5%) received clindamycin and 56,426 (95%) received cephalosporins. Cox regression analyses were performed with adjustment for sex, age groups, diagnosis, and ASA score. Survival times were calculated using Kaplan–Meier estimates and compared using Cox regression with revision for PJI as endpoint. The cephalosporins cefalotin and cefazolin were also compared. Results: Of the TKRs included, 1.3% (n = 743) were revised for PJI. 96% (n = 713) had received cephalosporins and 4% (n = 30) clindamycin for perioperative prophylaxis. Comparing cephalosporins (reference) and clindamycin, at 3-month follow-up the adjusted hazard ratio rate (HRR) for PJI was 0.7 (95% confidence interval [CI] 0.4–1.4), at 1 year 0.9 (CI 0.6–1.5), and at 5 years 0.9 (CI 0.6–1.4). Analysis using propensity score matching showed similar results. Furthermore, comparing cefalotin (reference) and cefazolin, HRR was 1.0 (CI 0.8–1.4) at 3 months and 1.0 (CI 0.7–1.3) at 1-year follow-up. Conclusion: We found no difference in risk of revision for PJI when using clindamycin compared with cephalosporins in primary cemented TKRs. It appears safe to continue the use of clindamycin in penicillin- or cephalosporin-allergic patients.en_US
dc.language.isoengen_US
dc.publisherMedical Journals Swedenen_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/deed.no*
dc.titleNo difference in risk of revision due to infection between clindamycin and cephalosporins as antibiotic prophylaxis in cemented primary total knee replacements: a report from the Norwegian Arthroplasty Register 2005–2020en_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2023 the authorsen_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doi10.2340/17453674.2023.16907
dc.identifier.cristin2180352
dc.source.journalActa Orthopaedicaen_US
dc.source.pagenumber404-409en_US
dc.identifier.citationActa Orthopaedica. 2023, 94, 404-409.en_US
dc.source.volume94en_US


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Navngivelse-Ikkekommersiell 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse-Ikkekommersiell 4.0 Internasjonal