A new GIRFT guide on antibiotic prophylaxis in arthroplasty describes the key principles surgical teams should have in place to help prevent surgical site and periprosthetic joint infection during joint replacement surgery. 

It aims to reduce variation in antibiotic prescribing practice across NHS trusts.  It will also form part of the assessment of surgical hubs going through the GIRFT hub accreditation process.  

This guidance serves as a practical tool to embedding appropriate surgical antibiotic prophylaxis for all primary arthroplasty procedures, including hips, knees, shoulders, elbows and ankles. It is supplementary to and consistent with the guidance provided in the Ambulatory Hip and Knee Replacement Guide from the GIRFT programme, as well as the pathways for primary total hip replacement and primary knee replacement 

Surgical antibiotic prophylaxis is a preventive strategy to reduce the risk of surgical site infections (SSIs) in orthopaedic procedures. 

The guide advises that all NHS trusts should have an agreed protocol for surgical antibiotic prophylaxis, and provides information on which antibiotic to give, when to give it and how long for, recognising the opportunities for standardisation across the dosing regimen to optimise infection prevention, reduce adverse events associated with surgical antibiotic prophylaxis, and ensure the judicious use of antimicrobials. 

Rhidian Morgan-Jones, President of the Bone and Joint Infection Society and Consultant Orthopaedic Surgeon at the East Suffolk and North Essex NHS Foundation Trust working as part of a stakeholder group to develop the guide, said: