Antibiotic prophylaxis for joint replacement surgery: the current practice in Britain

Although over a hundred thousand hip and knee joint replacement procedures are now undertaken in Britain every year, deep infection following surgery remains a concern. Measures to minimise this risk of infection include administration of prophylactic antibiotics but unfortunately with the lack of national guidelines, much variability exists between each hospital's local prescribing policies. We undertook a national survey to highlight this by interviewing Orthopaedic trainees at 52 randomly selected hospitals. A structured telephone questionnaire was used. Although all the hospitals were found to prescribe antibiotic prophylaxis, only 33 of the hospitals surveyed had strict local guidelines in place. Most hospitals administer cephalosporins (46), with only a few still relying on penicillins (3). Only four of the surveyed hospitals administer any prohylaxis against methicillin resistant staphyloccus aureus, such as Teicoplanin. Our results highlight the need for national guidelines to be implemented to improve our practice of joint replacement surgery.