Extended Oral Antibiotic Prophylaxis After Aseptic Revision Total Hip Arthroplasty: Does It Decrease Infection Risk?

Brandon R. Bukowski, Aaron R. Owen, Travis W. Turner, Kristin M. Fruth, Douglas R. Osmon, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review


Background: Extended oral antibiotic prophylaxis (EOA) has been shown to reduce infection after high-risk primary total hip arthroplasties (THAs) and reimplantations. However, data are limited regarding EOA after aseptic revision THAs. This study evaluated the impact of EOA on infection-related outcomes after aseptic revision THAs. Methods: We retrospectively identified 1,107 aseptic revision THAs performed between 2014 and 2019. Patients who received EOA >24 hours perioperatively (n = 370) were compared to those who did not (n = 737) using an inverse probability of treatment weighting model. Their mean age was 65 years (range, 19-98 years), mean body mass index was 30 kg/m2 (range, 16-72), and 54% were women. Outcomes included cumulative probabilities of any infection, periprosthetic joint infection (PJI), and re-revision or reoperation for infection. Mean follow-up was 4 years (range, 2-8 years). Results: The cumulative probability of any infection after aseptic revision THA was 2.3% at 90 days, 2.7% at 1 year, and 3.5% at 5 years. The cumulative probability of PJI was 1.7% at 90 days, 2.1% at 1 year, and 2.8% at 5 years. There was a trend toward an increased risk of any infection (hazards ratio [HR] = 2.6; P = .058), PJI (HR = 2.6; P = .085), and re-revision (HR = 6.5; P = .077) or reoperation (HR = 2.3; P = .095) for infection in patients who did not have EOA at the final clinical follow-up. Conclusions: EOA after aseptic revision THA was not associated with a statistically significant decreased risk of any infection, PJI, or re-revision or reoperation for infection at all time points. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)2460-2465
Number of pages6
JournalJournal of Arthroplasty
Issue number12
StatePublished - Dec 2022


  • aseptic revision
  • extended oral antibiotic prophylaxis
  • infection
  • periprosthetic joint infection (PJI)
  • revision total hip arthroplasty (THA)

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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