Single-Dose Prophylaxis Noninferior to Multiple Doses in Hip Arthroplasty

This nationwide target trial emulation supports stewardship efforts to limit perioperative prophylaxis to a single preoperative dose in primary total hip arthroplasty without increasing periprosthetic joint infection risk.

cefuroximecefazolinpenicillinase-resistant penicillinssurgical antibiotic prophylaxisperiprosthetic joint infectiontotal hip arthroplastyantimicrobial stewardshiptarget trial emulationcomparative effectivenesssingle-dose prophylaxis Infectious Disease / Antimicrobials

Background Information

Single antibiotic dose matches multiple doses in hip surgery infection prevention.

Reducing antibiotic use without increasing infection risk in surgery can decrease antimicrobial resistance and medication side effects. Single-dose antibiotic prophylaxis was noninferior to multiple doses for preventing periprosthetic joint infection (PJI), with similar infection rates in both groups. Although single-dose prophylaxis is as effective as multiple doses, further confirmation from randomized trials is needed before widespread adoption. Single-dose antibiotic prophylaxis may be sufficient for preventing infection post-hip arthroplasty.

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Authors: Abedi AA, Anneberg M, Pedersen AB, Varnum C, Christensen R, Overgaard S

Citation: Abedi AA, Anneberg M, Pedersen AB, et al. Single- vs Multiple-Dose Antibiotic Prophylaxis for Total Hip Arthroplasty. JAMA network open. 2026;9(9):e2634586. doi:10.1001/jamanetworkopen.2026.34586

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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