Perioperative antibiotic prophylaxis. Use in orthopaedics

Perioperative antibiotic prophylaxis in orthopaedics is only indicated if a foreign body such as a prosthetic joint remains in the operation site. For this indication first or second generation cephalosporins should be preferred. It is essential to administer the antibiotic within 30 min before incision. In the case of an extended intervention (more than 3 h) a repeated dose should be considered. It is evidence-based that prolonged perioperative antibiotic prophylaxis (more then 24 h) is not beneficial. To avoid the emergence of resistances or hygienic insufficiencies surveillance of surgical site infections should be enforced. Optimal conditions are necessary to achieve a rate of surgical site infection in orthopaedics below 1% in patients with normal infection risk profile.