Minimally Invasive Total Knee Arthroplasty Medication
- Author: Derek F Amanatullah, MD, PhD; Chief Editor: Erik D Schraga, MD more...
The goals of pharmacotherapy are to reduce morbidity and prevent complications.
The American Academy of Orthopaedic Surgeons has recommended the use of prophylactic antibiotics that include cefazolin, cefuroxime, or vancomycin. The antibiotics should be administered 60 minutes prior to the procedure and discontinued within 24 hours of the procedure. However, for outpatient/office-based procedures, a single preprocedure dose is sufficient.
Cefazolin is a first-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth.
Cefuroxime is a second-generation cephalosporin that maintains the gram-positive activity of first-generation cephalosporins; it adds activity against Proteus mirabilis, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, and Moraxella catarrhalis. The condition of the patient, the severity of the infection, and the susceptibility of the microorganism determine the proper dose and route of administration.
Vancomycin is a potent antibiotic that is directed against gram-positive organisms and that is active against Enterococcus species. It is useful in the treatment of septicemia and skin structure infections. Vancomycin is indicated for patients who cannot receive or have not responded to penicillins and cephalosporins and for patients who have infections with resistant staphylococci.
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