The effect of antibiotic therapy on the incidence of Staphylococcus aureus infections in orthopaedic patients.

Background: This paper reports on aetiological factors, including mostly S. aureus infections, and antibiotic use in the pretreatment and treatment of complicating infections in patients hospitalised at the Department of Orthopaedics and Musculoskeletal Traumatology, Gdańsk Medical University, between 1995 and 2004. The analysis sought to establish a correlation, via statistical analysis, between the usage of specific antibiotic classes, with special regard to lincosamides, and S. aureus infection rates.

Materials And Methods: The study population included 22,686 patients admitted for elective surgery (accounting for 86.9% to 75.1% of the sample in different years) or with acute injuries.

Results: The rate of infections ranged from 2.79% to 1%, decreasing in a statistically significant manner over time. S. aureus was the dominant pathogen, accounting for 67.3% to 27.6% of the total number of bacterial strains. During the time frame of the study, the incidence of osteitis fell considerably, from 0.8% to 0.05% of the total number of patients. This was paralleled by a major increase in the use of lincosamides, mostly clindamycin. The increase in lincosamide use correlated with the decreasing incidence of S. aureus infections.

Conclusions: The statistical outcome of this 10-year study has been used to develop schemes of antibiotic therapy in the Department, a necessary component of the Hospital's economic policy at the moment.A major fall in the incidence of nosocomial infections can be achieved by focussing on adequate antibiotic prophylaxis, pretreatment and appropriate treatment of acute infections.