Efficacy of Prophylactic Cefazoline and Vancomycin in Hip and Knee Surgery: A Systematic Review and Meta-analysis

Background and Antibiotic prophylaxis is an effective strategy for reduction of postoperative infection. Prophylactic cefazolin and vancomycin are used in patients undergoing hip and knee surgeries. The aim of this meta-analysis was to determine the knee and hip infection after surgery in patients under cefazolin and vancomycin regimen/s.
A literature search was performed in electronic databases including Google scholar, Pubmed, Web of science, and Scopus. The search keywords were hip, knee, cefazolin, and vancomycin. Eligible articles were determined after considering the inclusion/exclusion criteria. Finally, the heterogeneity among the results were defined by Q and I2 tests. Prevalence of infection were determined via randomized effect model based on heterogeneity results.
The meta-analysis included 19 articles in which hip and knee infections were investigated in 77108 patients. Prevalence of infection (95% confidence interval) in patients receiving cefazolin, vancomycin, and both antibiotics was 1.2% (0.9-1.5), 0.9% (0.04-1.7), and 1.3% (1.04-1.6), respectively.
Current results showed low rates of postoperative knee and hip infections. There was no significant difference between the types of these antibiotics.