Risk of Obtaining Routine Cultures During Presumed Aseptic Orthopaedic Procedures


Treating patients with antibiotics that are selected based on routine cultures obtained from presumed aseptic orthopaedic procedures may lead to an increased risk of antibiotic-related complications without reducing the rate of late deep infection. Routine cultures obtained from 60 of 169 procedures resulted in 23 (38.3%) positive and 37 (61.7%) negative results. Twenty-two patients (13.5%) developed late infections. Seven of 14 patients with positive cultures, who were treated with antibiotics, developed a late infection, while two of nine patients with routine cultures, who received no antibiotic treatment, developed a late infection. Six of 37 patients with negative cultures and seven of 109 patients with no cultures developed a late infection. In patients who developed late deep infection, the microorganism isolated on routine culture only corresponded to the microorganism causing late infection 55.5% of the time. Of all patients treated with antibiotics, seven (29%) experienced an antibiotic-related complication (p D .01). (Journal of Surgical Orthopaedic Advances 26(4):239–245, 2017) Key words: antibiotic-related complications, aseptic, orthopaedic procedures, routine cultures

MAJ Matthew A. Napierala, MD; MAJ Jaime L. Bellamy, DO; COL Clinton K. Murray, MD; CPT Richard K. Hurley, Jr., MD; Joseph C. Wenke, PhD; and Joseph R. Hsu, MD