Which antibiotic is used for prophylaxis in prosthetic joint replacement?

Which antibiotic is used for prophylaxis in prosthetic joint replacement?

• A. Keflex
• B. Amoxicillin
• C. Azithromycin
• D. Clindamycin

Answer: (A)

Prophylaxis for prosthetic joint replacement focuses on preventing infection from skin flora, especially Staphylococcus species, which are the most common culprits. A first-generation cephalosporin provides reliable coverage against these organisms and is commonly used in the perioperative setting. Keflex, the oral form of cephalexin, fits well for preoperative prophylaxis because it offers strong activity against Staphylococcus and Streptococcus and is convenient for outpatient use. Amoxicillin doesn’t cover Staphylococcus as reliably in this context, azithromycin lacks sufficient activity against these Gram-positive cocci, and while clindamycin can be used in penicillin-allergic patients, it has more concerns about C. difficile risk and variable MRSA coverage. Thus Keflex is the best choice for this prophylactic scenario.

Prophylaxis for prosthetic joint replacement focuses on preventing infection from skin flora, especially Staphylococcus species, which are the most common culprits. A first-generation cephalosporin provides reliable coverage against these organisms and is commonly used in the perioperative setting. Keflex, the oral form of cephalexin, fits well for preoperative prophylaxis because it offers strong activity against Staphylococcus and Streptococcus and is convenient for outpatient use. Amoxicillin doesn’t cover Staphylococcus as reliably in this context, azithromycin lacks sufficient activity against these Gram-positive cocci, and while clindamycin can be used in penicillin-allergic patients, it has more concerns about C. difficile risk and variable MRSA coverage. Thus Keflex is the best choice for this prophylactic scenario.