The use of prophylactic antibiotics in podiatric foot and ankle surgery

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Butterworth, P, Terrill, A, Barwick, A & Hermann, R 2017, 'The use of prophylactic antibiotics in podiatric foot and ankle surgery', Infection, Disease & Health, vol. 22, no. 1, pp. 6-11.

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Infection is a common and serious complication following surgery. Whether antibiotic prophylaxis reduces infection rates in podiatric foot and ankle surgery is unclear. The aim of this prospective cohort study therefore, was to determine the impact of antibiotic use on infection rates following podiatric foot and ankle surgery.


Data from 4238 patients who underwent foot and ankle surgery between January 2014 and January 2016 were analysed. Infections within the first 30 days following surgery were recorded according to the Australasian College of Podiatric Surgeons national audit descriptors. Logistic regression analyses were undertaken to determine whether antibiotic prophylaxis decreased the rate of surgical site infection.


Of the 4238 patient records, 4140 records (98%) provided complete data (aged 2–92 years, mean 48.9 ± SD 19.6, 1124 males, and 3016 females). A total of 79 infections (1.9% infection rate) were reported. More experienced surgeons documented a lower rate of infection (OR 0.36, 95% CI 0.17–0.72, P < 0.01) and the use of perioperative antibiotics was associated with lower infection rates than those that received no antibiotics (OR 0.42, 95% CI 0.22–0.81, P = 0.01). There was no significant association found between age, sex, and ASA score with infection. The use of postoperative antibiotics alone and in addition to perioperative antibiotics was not associated with reduced surgical site infection rates.


Surgeon experience may influence infection rates in podiatric foot and ankle surgical practice, and the use of perioperative antibiotics may reduce the risk of infection. The use or addition of postoperative antibiotics does not reduce infection rates, and should be used by podiatric surgeons with caution.

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