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Surgical site infection rate is higher following hip and knee arthroplasty when cefazolin is underdosed

18 Nov 2021

Many guidelines for prevention of surgical site infection recommend higher doses of cefazolin for those with higher body weight, however there is little outcome data to support the benefit of giving a higher dose.

This study, authored by the Health Quality & Safety Commission's clinical lead for the infection prevention and control programme, Dr Arthur Morris, analysed the surgical site infection rate following hip or knee arthroplasty, by the dose of cefazolin used. It concluded that patients undergoing hip or knee arthroplasty and weighing 80–120kg should receive 2g–3g of cefazolin respectively for SSI prophylaxis. The question of whether 4g or more of cefazolin is needed for those 120kg or more, or above a certain BMI, remains unanswered.