Adding vancomycin to antibiotic prophylaxis in patients undergoing arthroplasty does not prevent surgical site infections, shows a real-world Australian study.

In fact, the risk of infection was higher for cefazolin prophylaxis plus vancomycin in adults having knee replacement surgery, doctors report.

While the practice of adding a glycopeptide antimicrobial such as vancomycin to beta-lactam prophylaxis in arthroplasty provides a broader spectrum of activity, the Monash University, Melbourne-led team said the benefits were unclear.

As part of the Australian Surgical Antibiotic Prophylaxis trial, they assessed outcomes in some 4200 adults without known methicillin-resistant Staphylococcus aureus who underwent arthroplasty — primarily hip and knee.