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Vet Surg. 2018 Nov;47(8):E79-E87. doi: 10.1111/vsu.12958. Epub 2018 Sep 28.

A prospective, randomized, double-blinded, placebo-controlled clinical study on postoperative antibiotherapy in 150 arthroscopy-assisted tibial plateau leveling osteotomies in dogs.

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1
Metropolitan Veterinary Hospital, Copley, Ohio.

Erratum in

Abstract

OBJECTIVE:

To determine the influence of a 7-day course of postoperative antibiotherapy (cefpodoxime) on surgical site infections (SSI) after tibial plateau leveling osteotomy (TPLO).

STUDY DESIGN:

Prospective, randomized, double-blinded, placebo-controlled clinical study.

SAMPLE POPULATION:

One hundred fifty client-owned dogs, with consent.

METHODS:

Dogs undergoing arthroscopy-assisted TPLO were randomly assigned to 1 of 2 groups, the placebo group receiving perioperative cefazolin and 7 days of placebo medication after surgery or the treatment group receiving perioperative cefazolin and 7 days of postoperative cefpodoxime. Twenty-seven factors were analyzed for association with SSI by using univariate analysis, Fisher's exact test, or Wilcoxon rank-sum test.

RESULTS:

SSI rates did not differ (P = .34) between the placebo group (17%; 95% confidence level [CL] 7.94%-26.43%) and the treatment group (11% SSI; 95% CL 3.98%-18.88%). The probability that > 23% of dogs would benefit from postoperative antibiotherapy was less than 5%. The only association between the factors tested in this study and SSI involved the body weight (kg), with each 1 unit increase in kilogram weight increasing the odds of developing an SSI by 4.7%.

CONCLUSION:

Although the wide CL may be consistent with a type II error, a 7-day course of cefpodoxime after arthroscopy-assisted TPLO did not influence postoperative SSI in the population tested here. In addition, only a small proportion of dogs would benefit from postoperative antibiotherapy under the conditions of our study.

CLINICAL SIGNIFICANCE:

These results should prompt surgeons to reconsider systematic antibiotherapy after TPLO and justify additional studies to determine whether dogs predisposed to infection could benefit from such an approach.

PMID:
30267441
DOI:
10.1111/vsu.12958
[Indexed for MEDLINE]

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