A prospective, randomized, double-blinded, placebo-controlled clinical study on postoperative antibiotherapy in 150 arthroscopy-assisted tibial plateau leveling osteotomies in dogs

Vet Surg. 2018 Nov;47(8):E79-E87. doi: 10.1111/vsu.12958. Epub 2018 Sep 28.


Objective: To determine the influence of a 7-day course of postoperative antibiotherapy (cefpodoxime) on surgical site infections (SSI) after tibial plateau leveling osteotomy (TPLO).

Study design: Prospective, randomized, double-blinded, placebo-controlled clinical study.

Sample population: One hundred fifty client-owned dogs, with consent.

Methods: Dogs undergoing arthroscopy-assisted TPLO were randomly assigned to 1 of 2 groups, the placebo group receiving perioperative cefazolin and 7 days of placebo medication after surgery or the treatment group receiving perioperative cefazolin and 7 days of postoperative cefpodoxime. Twenty-seven factors were analyzed for association with SSI by using univariate analysis, Fisher's exact test, or Wilcoxon rank-sum test.

Results: SSI rates did not differ (P = .34) between the placebo group (17%; 95% confidence level [CL] 7.94%-26.43%) and the treatment group (11% SSI; 95% CL 3.98%-18.88%). The probability that > 23% of dogs would benefit from postoperative antibiotherapy was less than 5%. The only association between the factors tested in this study and SSI involved the body weight (kg), with each 1 unit increase in kilogram weight increasing the odds of developing an SSI by 4.7%.

Conclusion: Although the wide CL may be consistent with a type II error, a 7-day course of cefpodoxime after arthroscopy-assisted TPLO did not influence postoperative SSI in the population tested here. In addition, only a small proportion of dogs would benefit from postoperative antibiotherapy under the conditions of our study.

Clinical significance: These results should prompt surgeons to reconsider systematic antibiotherapy after TPLO and justify additional studies to determine whether dogs predisposed to infection could benefit from such an approach.

Publication types

  • Clinical Trial, Veterinary

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Arthroscopy / adverse effects
  • Arthroscopy / veterinary*
  • Cefazolin / administration & dosage
  • Cefazolin / therapeutic use
  • Dogs / injuries*
  • Dogs / surgery
  • Double-Blind Method
  • Female
  • Male
  • Osteotomy / adverse effects
  • Osteotomy / veterinary*
  • Perioperative Care / veterinary
  • Postoperative Care / veterinary
  • Prospective Studies
  • Random Allocation
  • Statistics, Nonparametric
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control
  • Surgical Wound Infection / veterinary*
  • Tibia / surgery*
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Cefazolin