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Comment & Response
June 23, 2022

Prophylactic Antibiotic Regimens in Tumor Resection Surgery Involving a Prosthesis—Reply

Author Affiliations
  • 1Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  • 2Department of Medicine, McMaster University, Hamilton, Ontario, Canada
JAMA Oncol. 2022;8(8):1222-1223. doi:10.1001/jamaoncol.2022.2059

In Reply We are grateful for the opportunity to respond to the comments from Drs Veerman and Wertheim regarding our study, the Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) trial.1 We thank Drs Veerman and Wertheim for their interest in our study and for highlighting the challenges of prescribing intravenous antibiotic prophylaxis in high-risk orthopedic cancer surgeries. The PARITY trial methods were designed by the PARITY Steering Committee, of which experts in infectious diseases were critical members. The Steering Committee used the best available data on the following in the selection of the PARITY study treatment regimens: (1) standard of care in both orthopedic surgeries overall and in orthopedic oncology specifically2,3; (2) the most common organisms known to produce and colonize prosthetic-associated biofilm (Staphylococcus aureus and Staphylococcus epidermidis)4; (3) the susceptibility of these organisms to bactericidal cephalosporins5; and (4) the need to focus on patient safety and minimize the use of multiple intravenous antibiotics in patients in whom disruption of the gut microbiome could be catastrophic. The fact that 55 clinical sites across 12 countries readily accepted the study protocol indicates that the choice of regimen was globally considered to be clinically sound and acceptable for patient safety.

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