Hip Surgery Prophylaxis Guidelines

Standard Prophylaxis Recommendation

The American College of Surgeons recommends cefazolin 2g as the established standard for hip arthroplasty prophylaxis, which is sufficient as monotherapy 1
The American Academy of Orthopaedic Surgeons suggests that cefazolin is equally effective as ceftriaxone for surgical site infection prevention, with no advantage to using third-generation cephalosporins, and multiple studies show equivalent SSI rates between cefazolin and ceftriaxone (1.5% vs 1.7% in prosthetic joint surgery) 1

The American College of Surgeons recommends administering 2g IV within 30-60 minutes before surgical incision, ideally 30 minutes prior, and redosing with 1g if surgical duration exceeds 4 hours (based on cefazolin's half-life) 2
The American Academy of Orthopaedic Surgeons suggests discontinuing cefazolin within 24 hours postoperatively, as extending beyond this provides no benefit and increases resistance risk 2, 3

The American Academy of Orthopaedic Surgeons recommends cefazolin 2g alone as the appropriate choice for hip surgery prophylaxis, providing adequate coverage against typical surgical pathogens (S. aureus, S. epidermidis, gram-negative bacteria) for hip arthroplasty 4