From the Research
After hallux valgus correction surgery, the most appropriate oral antibiotic regimen for the "tail" portion of treatment is cephalexin 500mg four times daily for 5-7 days, as supported by the most recent and highest quality study 1. This regimen is chosen to prevent surgical site infections while the initial healing process begins. The choice of antibiotic should be guided by patient-specific factors such as:
- Allergy history
- Renal function
- Local bacterial resistance patterns Alternatives for patients with penicillin allergies include:
- Clindamycin 300mg four times daily
- Doxycycline 100mg twice daily for the same duration Antibiotics should be started immediately post-surgery and continued until the initial wound check, typically around 5-7 days. It's essential to note that prolonged antibiotic use beyond this period is generally not recommended unless signs of infection are present, as it may contribute to antibiotic resistance 2. Patients should be instructed to take the full course as prescribed, even if symptoms improve, and to report any signs of infection such as increased pain, redness, warmth, swelling, or drainage from the surgical site. The most recent study on the management of Staphylococcus aureus bacteremia 2 emphasizes the importance of appropriate antibiotic treatment, which can be applied to the prevention of surgical site infections in hallux valgus correction surgery. Additionally, the study on fourth-generation minimally invasive and open hallux valgus surgery 3 highlights the need for standardized outcome measures and long-term follow-up, which includes monitoring for signs of infection and adjusting antibiotic treatment accordingly. However, the specific details of antibiotic treatment are not addressed in this study, and therefore, the recommendation is based on the most relevant and recent study available 1.