Are Antibiotics Needed Routinely for Arthroscopic Surgery?

Patients who have arthroscopic surgery on any joint are at increased risk for infection. Those who have joint replacements could be in danger of implant failure from infection. The use of antibiotics to prevent infection is called prophylaxis. Prophylactic use of antibiotics is a form of “defensive medicine.”

The over use of antibiotics has led to bacteria that are resistant to antibiotics. Should everyone get antibiotics to keep this from happening?

In this report, Dr. P. R. Kurzweil from the Southern California Center for Sports Medicine offers his opinions about the use of antibiotics for arthroscopic surgery. His arguments are all in favor of prophylactic antibiotics. He gives the following reasons:

  • Prevents infection from mistakes made in sterile procedures (human error)
  • Prevents deep infection that would require more surgery
  • Helps high-risk patients who are at increased risk of infection from other
    problems such as diabetes, immune disorders, or skin problems
  • Protects the surgeon in case of a lawsuit over infection; use of antibiotics shows the doctor took every step to avoid this problem
  • Offsets the risk of infection for some of today's arthroscopic operations that are long and complex

    Some experts argue against the routine use of antibiotics. For one thing it's expensive. And the actual risk of infection with arthroscopic surgery is very low. Patients are exposed to something they may be allergic to or that could result in resistant bacteria if an infection does occur.

    Prophylactic antibiotics don't prevent all infections but they do reduce the risk. The author advises use whenever any incision is made no matter how small. It's less expensive to give everyone a prophylactic antiobiotic than to treat the small number of patients with infection using intravenous antibiotics.



    References: Peter R. Kurzweil, MD. Antibiotic Prophylaxis for Arthroscopic Surgery. In Journal of Arthroscopy and Related Research. April 2006. Vol. 22. No. 4. Pp. 452-454.

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