RCT | High-dose dual-antibiotic cement doesn’t lower infection rates in hip hemiarthroplasty

Summary: This randomized superiority trial studied the effect of high-dose dual-antibiotic loaded cement versus standard care single-antibiotic loaded cement on deep surgical site infection (SSI) rates in hip hemiarthroplasty patients. This large-scale study, conducted in 26 UK hospitals, included people aged 60 and older with a hip fracture.

The trial randomly allocated 4936 participants to either treatment group. The primary outcome was deep SSI at 90 days post-randomisation. Notably, no significant difference was found between the groups. About 1.7% of participants in the single-antibiotic group and 1.2% in the dual-antibiotic group experienced a deep SSI (adjusted odds ratio 1.43; 95% CI 0.87–2.35; p=0.16). This result contradicts previous findings suggesting that high-dose dual-antibiotic cement could reduce infection rates.

Article: High-dose dual-antibiotic loaded cement for hip hemiarthroplasty in the UK (WHiTE 8): a randomised controlled trial – The Lancet

News release: Antibiotic bone cement found not to reduce infection after hip replacement – University of Oxford