Orthopedic
Prophylactic antistaphylococcal drugs administered preoperatively can decrease the incidence of both early and late infection following joint replacement. They also decrease the rate of infection in compound or open fractures and when hip and other fractures are treated with internal fixation by nails, plates, screws or wires. If a proximal tourniquet is used for the procedure, the antibiotic infusion must be completed prior to its inflation. One large randomized trial found a single dose of a cephalosporin more effective than placebo in preventing wound infection after surgical repair of closed fractures. A prospective randomized study in patients undergoing diagnostic and operative arthroscopic surgery concluded that antibiotic prophylaxis is not indicated.