Antibiotic stewardship is a big deal, as is evident from a “Chart of the Week” in CORRelations, reproduced below.
The most common indication that we orthopaedic surgeons get wrong is our use of preoperative antibiotics. How many times have you heard, “this patient is allergic to penicillin. Can we give [NAME OF NON-CEPHALOSPORIN ANTIBIOTIC HERE] instead?” This frustrates me, all the more so when no one even knows what the supposed allergy is.
In almost every such instance, we should stand firm and use the usual cephalosporin antibiotic. The evidence is on our side. It is abundantly clear that cefazolin is the best perioperative antibiotic to administer, and giving something else violates best-practices of antibiotic stewardship and increases the risk of perioperative infection. So, the next time you hear “can we give ‘X’ instead,” unless there is a compelling reason to do otherwise, reply with “No, let’s go with the cefazolin!” You’ll feel better, and your patient will be better off.