A Randomize Control Trial between Fosfomycin and Cefuroxime as the Antibiotic Prophylaxis in Knee Arthroplasty
Keerati Chareancholvanich MD, FRCOST*, Pacharapol Udomkiat MD, FRCOST*, Saranatra Waikakul MD, FRCOST*
Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Antibiotic prophylaxis is used in all patient underwent total knee arthroplasty to prevent post operative infection
which produced poor outcome. The suitable drug should be safe and good efficacy.
Objective : To study safety and efficacy of fosfomicin and cefuroxime as antibiotic prophylaxis for total knee arthroplasty.
Material and Method: The control trial was performed to find out efficacy and safety of fosfomycin as an antibiotic
prophylaxis comparing to cefuroxime. There were 112 patients, 14 male and 98 female, with their ages ranged between 57 and
86 years. They were randomly divided into two groups, the fosfomycin group, 56 patients and the cefuroxime group, 56
patients. All patients underwent elective knee arthroplasty by the authors. The scheduled antibiotics were given perioperatively
for 24 hours and all patients were followed-up for 6 months. Physical examination, skin temperature of the operated knee,
radiograph and blood tests were carried out in the patients to monitor post operative infection, renal and liver disturbance.
Results : One patient in the cefuroxime group had local wound infection which responded well to local treatment and
administration of antibiotics. No patients had post operative infection at the 6 months follow-up. No patients had any
complication and none had renal and liver function disturbance during the follow-up.
Conclusion : Comparing to cefuroxime, fosfomycin is safe and effective for the use as antibiotic prophylaxis in knee arthroplasty.
Keywords : Antibiotic prophylaxis, Wound infection, Fosfomicin, Total knee arthroplasty
