Vancomycin not the answer

A CLINICAL trial, published today in the New England Journal of Medicine and led by Monash University researchers, has found that the addition of the antibiotic vancomycin after a knee surgery did not protect against infection and may have led to more infections and more adverse reactions for patients in Australia.

Current standard practice includes the administration of cefazolin at the time of surgery to prevent infection, however the rise in antibiotic resistant bacteria has led experts to consider adding a second antibiotic, such as vancomycin to prevent more infection.

Many centres in Australia and globally have adopted the practice of giving both cefazolin and vancomycin to prevent infections, despite the lack of clear benefits.

According to the study lead, Professor Trisha Peel, from the Monash University Central Clinical School, “given the number of joint replacements performed in Australia and globally, our trial has answered the important question about whether more antibiotics are better for our patients having joint replacement surgery.

“The definitive answer is ‘no’,” she said.

The Australian Surgical Antibiotic Prophylaxis trial looked at 4,239 patients without a MRSA history, in 11 hospitals, including regional and private hospitals in the country, finding the addition of vancomycin was no better than just using cefazolin.