Antimicrobial prophylaxis in total hip replacement: a systematic review.

The efficacy of many of the regimens studied may be similar, and available data make it difficult to identify an optimal regimen. There is no convincing evidence to suggest that the new-generation cephalosporins are more effective at preventing postoperative SWI infections in THR/TKR surgery than the first-generation cephalosporins. Similarly, there is no convincing evidence to suggest that extending the duration of a regimen beyond 24 hours postoperatively reduces the number of SWI following THR/TKR surgery. Single-dose or short-term administration is not only as effective as long-term administration, but will lower overall costs and may reduce the risk of toxicity and the development of bacterial resistance.