For patients undergoing foot and ankle surgery, preoperative oral antibiotics are standard of care. Yet, there is no consensus on the efficacy of this postsurgical protocol. For this study, researchers from the University of Tennessee Health Science Center in Memphis wanted to know whether postoperative oral antibiotics reduce the rate of surgical site infections (SSIs) in patients, with and without comorbidities, undergoing foot and ankle surgery.
They conducted a retrospective chart review, identifying patients who underwent foot and ankle surgery by 4 fellowship-trained, foot and ankle orthopaedic surgeons between January 1, 2015, and January 1, 2019. Patients were divided into 2 groups: those who received postoperative oral antibiotics (group 1) and those who did not (group 2). Two surgeons routinely prescribed postoperative oral antibiotics, and 2 did not. Demographics, comorbidities, and procedure complexity based on surgical site and Current Procedural Terminology code were recorded from the charts. The primary outcome was postoperative infection (superficial or deep) within 6 months after surgery. Patients with antibiotic use prior to surgery, preoperative infection, or lack of follow-up >6 weeks were excluded. Multivariate logistic regression modeling was used to analyze differences in infection rate and severity.
The results of this study indicate that postoperative oral antibiotics are not associated with differences in infection rates or severity. We do not recommend routine use in foot and ankle surgery.
Source: Frederick RM, Burnette H, Joyce M, et al. Efficacy of postoperative oral antibiotics in foot and ankle surgery. Foot Ankle Int. 2022 Sep;43(9):1204-1210. doi: 10.1177/10711007221099929.
