Clinical Report: Comparing Single and Multiple Doses of Antibiotics for Prophylaxis in Total Hip Arthroplasty

Overview

This study evaluates the effectiveness of a single preoperative antibiotic dose versus multiple doses in preventing periprosthetic joint infection (PJI) following total hip arthroplasty (THA). The findings indicate that a single dose is noninferior to multiple doses for reducing PJI risk within 90 days post-surgery, as reported in the study.

Background

Periprosthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA), leading to repeat surgeries and increased healthcare costs. Current guidelines on antibiotic prophylaxis vary, with some recommending multiple doses while others support a single preoperative dose, reflecting differing evidence. This inconsistency highlights the need for high-quality evidence to guide clinical practice.

Data Highlights

Key Findings

• A single preoperative antibiotic dose was found to be noninferior to multiple doses for preventing PJI.
• The PJI rates were 0.98% for the single dose group and 0.94% for the multiple dose group.
• Findings were consistent across sensitivity analyses and at 365 days post-surgery.
• The study utilized a robust nationwide data infrastructure for improved diagnostic accuracy.

Clinical Implications

The results indicate that a single preoperative antibiotic dose may be sufficient for prophylaxis in THA to reduce the risk of PJI.

Conclusion

The study provides evidence that a single preoperative antibiotic dose is sufficient for preventing PJI in primary THA.

Related Resources & Content

1. JAMA Network Open, 2026 -- Single- vs Multiple-Dose Antibiotic Prophylaxis for Total Hip Arthroplasty
2. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017
3. The ASCO Post, 2022 -- Single vs Multiple Doses of Prophylactic IV Antibiotics to Prevent Surgical Site Infection in Implant-Based Breast Reconstruction
4. Infection -- The Role of Antibiotic-Infused Cement Spacers in Reducing Reinfection Risk Following Septic Two-Stage Hip Revision Surgery
5. Archives of Orthopaedic and Trauma Surgery -- Effectiveness Comparison of Single-Stage and Two-Stage Revision Strategies for Hip Prosthetic Joint Infections
6. Archives of Orthopaedic and Trauma Surgery — Only a partial shield: local vancomycin postpones but does not prevent hip and knee prosthetic infections
7. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017
8. Single- vs Multiple-Dose Antibiotic Prophylaxis for Total Hip Arthroplasty | Orthopedics | JAMA Network Open | JAMA Network
9. Comparative effectiveness of antibiotic prophylaxis for preventing serious adverse events after primary total hip arthroplasty: a systematic review and network meta-analysis of randomized trials - PMC