Antibiotic Prophylaxis for Hip Fracture Surgery: Three-Dose Cefuroxime versus Single-Dose Gentamicin and Amoxicillin:

Purpose.To compare a 3-dose cefuroxime regimen with a single-dose gentamicin and amoxicillin regimen as antibiotic prophylaxis for hip hemiarthroplasty in terms of microbiological outcome.Methods.Records of 2 matched groups of patients who underwent hip hemiarthroplasty for femoral neck fractures were reviewed. 29 men and 84 women (mean age, 82 years) who received a 3-dose cefuroxime regimen in 2006 were compared with 23 men and 84 women (mean age, 83 years) who received a single-dose gentamicin and amoxicillin regimen in 2008. Patient demographics, antibiotics prescribed in the peri- and immediate postoperative period, microbiological evidence for Clostridium difficile ‘infection’, length of hospital stay, mortality, as well as biochemical and haematological findings were reviewed.Results.The 3-dose cefuroxime group was significantly higher in terms of the mean length of hospital stay (17 vs. 13 days, p=0.043) and the percentage of patients receiving postoperative antibiotics (88% vs. 68%, p<0.001) and h...