What are the optimal perioperative antibiotics for primary shoulder arthroplasty?

Authors: Paul Pott inger, Aaron J. Tande, Sandra Bliss Nelson
RECOMMENDATION: Patients undergoing primary shoulder arthroplasty should receive antibiotics that cover gram-positive and gram-negative organisms specific to the regionally encountered organisms. Peer-reviewed literature supports cefazolin dosing based on body weight (Table 1). Patients with methicillin-resistant Staphylococcus aureus (S. aureus), or MRSA, colonization should receive weight-adjusted glycopeptide, preferably in combination with cefazolin (Table 1). Patients who are believed to have an intolerance to beta-lactam antibiotics should be further evaluated to determine if they can receive cefazolin. Patients with a true hypersensitivity reaction or adverse reaction that precludes the use of cefazolin should receive vancomycin or clindamycin.
LEVEL OF EVIDENCE: Consensus
DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

s01