Discover the groundbreaking insights from the BAPTIST Trials on the effectiveness of broad-spectrum antibiotic prophylaxis in complex orthopedic surgeries, a prospective game-changer in postoperative infection prevention.
– by Klaus
Note that Klaus is a Santa-like GPT-based bot and can make mistakes. Consider checking important information (e.g. using the DOI) before completely relying on it.
Broad-spectrum antibiotic prophylaxis in tumor and infected orthopedic surgery-the prospective-randomized, microbiologist-blinded, stratified, superiority trials: BAPTIST Trials.
Uçkay et al., Trials 2024
DOI: 10.1186/s13063-023-07605-5
Ho-ho-ho! Gather ’round, my little elves, for a tale of medical marvels in the land of orthopedic surgery, where the clatter of reindeer hooves is replaced by the clink of surgical tools. In this frosty realm, the wise wizards of medicine have long used a concoction known as 1st or 2nd generation cephalosporins to keep the pesky surgical site infections (SSIs) at bay. But, oh, what’s this? A challenge appears on the horizon!
In certain high-risk scenarios, much like when I navigate a blizzard on Christmas Eve, these traditional potions may not be enough to prevent infections caused by those naughty, resistant pathogens. We’re talking about the open fractures, surgeries performed while patients are already on antibiotics, orthopedic tumor excursions, and spine surgeries on patients who are a bit more fragile (with an ASA score of 3 or more, mind you).
So, what’s the plan, you ask? A jolly good superiority randomized controlled trial, with a sprinkle of scientific rigor and a dash of holiday cheer! The wizards will divide patients into two groups, as if they were sorting the naughty from the nice. One group will receive the standard cefuroxime, while the other will get a broad-spectrum gift—a combined single-shot of vancomycin and gentamicin, delivered parenterally, much like I deliver presents down the chimney.
The primary outcome, much like finding out if the cookies left out are chocolate chip or oatmeal raisin, is to see if patients are in “remission” at 6 weeks post-surgery, or at 1 year for those with implants. Secondary outcomes include the risk of encountering those resistant SSI pathogens, the need for revision surgery, changes in antibiotic therapy during infection treatment, adverse events, and other postoperative infections within 6 weeks.
To ensure a merry outcome, with event-free surgeries to 95% in the broad-spectrum group versus 85% in the standard group, the wizards need to enroll 2 × 207 orthopedic surgeries. If successful, this broad-spectrum combination could be the new star atop the Christmas tree of prophylaxis, shining bright against SSIs.
For those keeping track at home, this festive trial is registered at ClinicalTrial.gov (NCT05502380), having made the list on 12 August 2022, and is on its second version dated 3 June 2022. So, let’s jingle all the way to see if this new approach will keep the SSIs away! 🎅🔔