e1ae6421401ecb1d5144b36cd80b0892 pmc_33924353.pdf 98362b5d609ff6699e91139a086008b1386ecc95 pmc_33924353.pdf 00ccc3c89280b7db385c033c8008ad71f0f3b392a2faa2cee39bc7e276afe7ea pmc_33924353.pdf Title: Periprosthetic Joint Infection Prophylaxis in the Elderly after Hip Hemiarthroplasty in Proximal Femur Fractures: Insights and Challenges Subject: We review antibiotic and other prophylactic measures to prevent periprosthetic joint infection (PJI) after hip hemiarthroplasty (HHA) surgery in proximal femoral fractures (PFFs). In the absence of specific guidelines, those applied to these individuals are general prophylaxis guidelines. Cefazolin is the most widely used agent and is replaced by clindamycin or a glycopeptide in beta-lactam allergies. A personalized antibiotic scheme may be considered when colonization by a multidrug-resistant microorganism (MDRO) is suspected. Particularly in methicillin-resistant Staphylococcus aureus (MRSA) colonization or a high prevalence of MRSA-caused PJIs a glycopeptide with cefazolin is recommended. Strategies such as cutaneous decolonization of MDROs, mainly MRSA, or preoperative asymptomatic bacteriuria treatment have also been addressed with debatable results. Some areas of research are early detection protocols in MDRO colonizations by polymerase-chain-reaction (PCR), the use of alternative antimicrobial prophylaxis, and antibiotic-impregnated bone cement in HHA. Given that published evidence addressing PJI prophylactic strategies in PFFs requiring HHA is scarce, PJIs can be reduced by combining different prevention strategies after identifying individuals who will benefit from personalized prophylaxis. Keywords: hip hemiarthroplasty; proximal femur fracture; antibiotic prophylaxis; periprosthetic joint infection; decolonization Author: Dolors Rodríguez-Pardo, Laura Escolà-Vergé, Júlia Sellarès-Nadal, Pablo S. Corona, Benito Almirante and Carles Pigrau Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Apr 13 09:47:22 2021 CEST ModDate: Tue Apr 13 09:50:58 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 6 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 244140 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OHKNFJ+VnURWPalladioL Type 1 Custom yes yes no 10 0 EWQVFQ+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 IBSKUX+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 YMQIRI+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 LXSBZD+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 37 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 59 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 63 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 67 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:19:54 CEST RepresentationInformation: pmc_33924353.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:52 CEST Size: 244140 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 207 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Current Antibiotic Prophylaxis in Proximal Femur Fractures Requiring Hip Hemiarthroplasty Destination: section.2 Item: Title: Current Challenges to Optimize Antibiotic Prophylaxis in Proximal Femur Fractures Requiring Hip Hemiarthroplasty Destination: section.3 Item: Title: Future Scenarios to Optimize Prosthetic Joint Infection Prophylaxis in Proximal Femur Fractures Requiring Hip Hemiarthroplasty Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Periprosthetic Joint Infection Prophylaxis in the Elderly after Hip Hemiarthroplasty in Proximal Femur Fractures: Insights and Challenges Author: Dolors Rodríguez-Pardo, Laura Escolà-Vergé, Júlia Sellarès-Nadal, Pablo S. Corona, Benito Almirante and Carles Pigrau Subject: We review antibiotic and other prophylactic measures to prevent periprosthetic joint infection (PJI) after hip hemiarthroplasty (HHA) surgery in proximal femoral fractures (PFFs). In the absence of specific guidelines, those applied to these individuals are general prophylaxis guidelines. Cefazolin is the most widely used agent and is replaced by clindamycin or a glycopeptide in beta-lactam allergies. A personalized antibiotic scheme may be considered when colonization by a multidrug-resistant microorganism (MDRO) is suspected. Particularly in methicillin-resistant Staphylococcus aureus (MRSA) colonization or a high prevalence of MRSA-caused PJIs a glycopeptide with cefazolin is recommended. Strategies such as cutaneous decolonization of MDROs, mainly MRSA, or preoperative asymptomatic bacteriuria treatment have also been addressed with debatable results. Some areas of research are early detection protocols in MDRO colonizations by polymerase-chain-reaction (PCR), the use of alternative antimicrobial prophylaxis, and antibiotic-impregnated bone cement in HHA. Given that published evidence addressing PJI prophylactic strategies in PFFs requiring HHA is scarce, PJIs can be reduced by combining different prevention strategies after identifying individuals who will benefit from personalized prophylaxis. 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