Total knee arthroplasty is one of the major orthopedic surgeries, with approximately 70,000 performed every year in South Korea. Although  post-operative satisfaction rate is more than 85% for advanced arthritis patients, various complications may occur because of insertion of a prothesis. Especially, because the prosthesis is inserted into the body, deep infection can occur post-operatively. Consequently, complete resolution of infection using simple antibiotic treatment is very rare and, in most cases, further surgery is required. The subsequent distress and financial burden to the patient, and the socioeconomic costs, are significant. 

Among the many preventative pre-surgical measures undertaken to prevent infection, prophylactic administration of appropriate antibiotics is accepted as an effective measure. The prophylactic use of appropriate antibiotic prescription in total knee arthroplasty has been recommended in the scientific literature and in various clinical practice guidelines. However, adherence to clinical practice guidelines is very low and optimal use for antibiotic prophylaxis is still debatable. 

The purpose of this study was to present the evidence for the use of prophylactic antibiotics for total knee arthroplasty, and to analyze the current state of antibiotic use and expert recognition in clinical practice.