Optimal timing and antibiotic prophylaxis in periprosthetic joint infection (PJI): literature review and world consensus (Part one)

The questions of type of antibiotics and optimal timing of administration for prophylaxis of PJI are of the most important ones for all arthroplasty surgeons. All delegates of consensus meeting on periprosthetic joint infection voted on the following statements regarding optimal timing and antibiotic prophylaxis for prevention of infection in hip and knee arthroplasties. Consensus: The preoperative dose of antibiotics should be administered within one hour of surgical incision; this can be extended to two hours for vancomycin and fluoroquinolones. Furthermore, surveillance measures are critical in ensuring clinician compliance with this ob-jective. Delegate vote: Agree: 97%, Disagree: 2%, Abstain: 1% (strong consensus) Consensus: A first or second-generation cephalosporin (cefazolin or cefuroxime) should be administered for routine perioperative surgical prophylaxis. Isoxazolyl penicillin is used as an appropriate alternative. Delegate vote: Agree: 89%, Disagree: 8%, Abstain: 3% (strong con-sensus)