ANTIBIOTIC-PROPHYLAXIS - THEORY AND REALITY IN ORTHOPEDICS

Marked differences were found when prophylactic antibiotic regimens an d accuracy of administration were compared in the orthopaedic trauma a nd elective surgery units of one city. Consultants carrying out electi ve, primary joint replacements advocated similar antibiotic policies. There was 100% compliance in correct prescription and over 99% in admi nistration of antibiotic doses. An audit of eight surgeons who underto ok emergency surgery on adult hip fractures found three different prop hylactic antibiotic regimens and that half of the consultants wished n o antibiotics to be given. Only 33% of the patients were prescribed th e schedule that their consultant wished and there were frequent inaccu racies in dose administration. Of 48 doses prescribed, five were omitt ed and in addition, four were recorded as having been given although t hey were unprescribed. Whilst antibiotic prophylaxis is universally ac cepted and the drugs are prescribed and administered accurately in cas es of elective joint arthroplasty, the converse is true for emergency hip surgery.