Effect of perioperative prophylactic antimicrobial treatment in dogs undergoing elective orthopedic surgery

Ted L. Whittem From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Ann L. Johnson From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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 DVM, MS, DACVS
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Charles W. Smith From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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David J. Schaeffer From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Bradley R. Coolman From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Scott M. Averill From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Timothy K. Cooper From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Graham R. Merkin From the Departments of Veterinary Biosciences (Whittem, Schaeffer, Cooper, Merkin) and Veterinary Clinical Medicine (Johnson, Smith, Coolman, Averill), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Objective

To determine whether perioperative antimicrobial prophylaxis would reduce incidence of postoperative infection among dogs undergoing elective orthopedic procedures.

Design

Randomized, controlled, blinded, intention clinical trial.

Animals

Dogs of any breed, sex, or age undergoing elective orthopedic surgery at a veterinary teaching hospital.

Procedures

Dogs were randomly assigned to 1 of 3 groups: treatment with saline solution, treatment with potassium penicillin G, and treatment with cefazolin. Treatments were intended to be administered within 30 minutes prior to surgery; a second dose was administered if surgery lasted > 90 minutes. Dogs were monitored for 10 to 14 days after surgery for evidence of infection.

Results

After the first 112 dogs were enrolled in the study, it was found that infection rate for control dogs (5/32 dogs) was significantly higher than the rate for dogs treated with antimicrobials (3/80 dogs). Therefore, no more dogs were enrolled in the study. A total of 126 dogs completed the study. Monte Carlo simulations indicated that compared with dogs that received antimicrobials prophylactically, dogs that received saline solution developed infections significantly more frequently. Difference in efficacy, however, was not observed between the 2 antimicrobial drugs used.

Conclusions and Clinical Relevance

Results indicated that perioperative antimicrobial prophylaxis decreased postoperative infection rate in dogs undergoing elective orthopedic surgery, compared with infection rate in control dogs. Cefazolin was not more efficacious than potassium penicillin G in these dogs. (J Am Vet Med Assoc 1999;215:212–216)

Objective

To determine whether perioperative antimicrobial prophylaxis would reduce incidence of postoperative infection among dogs undergoing elective orthopedic procedures.

Design

Randomized, controlled, blinded, intention clinical trial.

Animals

Dogs of any breed, sex, or age undergoing elective orthopedic surgery at a veterinary teaching hospital.

Procedures

Dogs were randomly assigned to 1 of 3 groups: treatment with saline solution, treatment with potassium penicillin G, and treatment with cefazolin. Treatments were intended to be administered within 30 minutes prior to surgery; a second dose was administered if surgery lasted > 90 minutes. Dogs were monitored for 10 to 14 days after surgery for evidence of infection.

Results

After the first 112 dogs were enrolled in the study, it was found that infection rate for control dogs (5/32 dogs) was significantly higher than the rate for dogs treated with antimicrobials (3/80 dogs). Therefore, no more dogs were enrolled in the study. A total of 126 dogs completed the study. Monte Carlo simulations indicated that compared with dogs that received antimicrobials prophylactically, dogs that received saline solution developed infections significantly more frequently. Difference in efficacy, however, was not observed between the 2 antimicrobial drugs used.

Conclusions and Clinical Relevance

Results indicated that perioperative antimicrobial prophylaxis decreased postoperative infection rate in dogs undergoing elective orthopedic surgery, compared with infection rate in control dogs. Cefazolin was not more efficacious than potassium penicillin G in these dogs. (J Am Vet Med Assoc 1999;215:212–216)

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