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Oral versus Intravenous Antibiotics for Bone and Joint Infection.
Li, Ho-Kwong; Rombach, Ines; Zambellas, Rhea; Walker, A Sarah; McNally, Martin A; Atkins, Bridget L; Lipsky, Benjamin A; Hughes, Harriet C; Bose, Deepa; Kümin, Michelle; Scarborough, Claire; Matthews, Philippa C; Brent, Andrew J; Lomas, Jose; Gundle, Roger; Rogers, Mark; Taylor, Adrian; Angus, Brian; Byren, Ivor; Berendt, Anthony R; Warren, Simon; Fitzgerald, Fiona E; Mack, Damien J F; Hopkins, Susan; Folb, Jonathan; Reynolds, Helen E; Moore, Elinor; Marshall, Jocelyn; Jenkins, Neil; Moran, Christopher E; Woodhouse, Andrew F; Stafford, Samantha; Seaton, R Andrew; Vallance, Claire; Hemsley, Carolyn J; Bisnauthsing, Karen; Sandoe, Jonathan A T; Aggarwal, Ila; Ellis, Simon C; Bunn, Deborah J; Sutherland, Rebecca K; Barlow, Gavin; Cooper, Cushla; Geue, Claudia; McMeekin, Nicola; Briggs, Andrew H; Sendi, Parham; Khatamzas, Elham; Wangrangsimakul, Tri; Wong, T H Nicholas.
Afiliação
  • Li HK; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Rombach I; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Zambellas R; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Walker AS; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • McNally MA; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Atkins BL; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Lipsky BA; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Hughes HC; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Bose D; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Kümin M; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Scarborough C; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Matthews PC; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Brent AJ; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Lomas J; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Gundle R; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Rogers M; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Taylor A; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Angus B; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Byren I; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Berendt AR; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Warren S; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Fitzgerald FE; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Mack DJF; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Hopkins S; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Folb J; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Reynolds HE; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Moore E; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Marshall J; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Jenkins N; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Moran CE; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Woodhouse AF; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Stafford S; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Seaton RA; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Vallance C; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Hemsley CJ; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Bisnauthsing K; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Sandoe JAT; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Aggarwal I; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Ellis SC; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Bunn DJ; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Sutherland RK; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Barlow G; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Cooper C; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Geue C; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • McMeekin N; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Briggs AH; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Sendi P; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Khatamzas E; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Wangrangsimakul T; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
  • Wong THN; From Oxford University Hospitals NHS Foundation Trust (H.-K.L., M.A.M., B.L.A., P.C.M., A.J.B., J.L., R.G., M.R., A.T., B.A., I.B., A.R.B., E.K., T.W., T.H.N.W., L.K.B., A.A., P.B., M.S.) and the Nuffield Departments of Orthopaedics, Rheumatology and Musculoskeletal Science (I.R., R.Z., C.C., A.A.)
N Engl J Med ; 380(5): 425-436, 2019 01 31.
Article em En | MEDLINE | ID: mdl-30699315
ABSTRACT

BACKGROUND:

The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication.

METHODS:

We enrolled adults who were being treated for bone or joint infection at 26 U.K. centers. Within 7 days after surgery (or, if the infection was being managed without surgery, within 7 days after the start of antibiotic treatment), participants were randomly assigned to receive either intravenous or oral antibiotics to complete the first 6 weeks of therapy. Follow-on oral antibiotics were permitted in both groups. The primary end point was definitive treatment failure within 1 year after randomization. In the analysis of the risk of the primary end point, the noninferiority margin was 7.5 percentage points.

RESULTS:

Among the 1054 participants (527 in each group), end-point data were available for 1015 (96.3%). Treatment failure occurred in 74 of 506 participants (14.6%) in the intravenous group and 67 of 509 participants (13.2%) in the oral group. Missing end-point data (39 participants, 3.7%) were imputed. The intention-to-treat analysis showed a difference in the risk of definitive treatment failure (oral group vs. intravenous group) of -1.4 percentage points (90% confidence interval [CI], -4.9 to 2.2; 95% CI, -5.6 to 2.9), indicating noninferiority. Complete-case, per-protocol, and sensitivity analyses supported this result. The between-group difference in the incidence of serious adverse events was not significant (146 of 527 participants [27.7%] in the intravenous group and 138 of 527 [26.2%] in the oral group; P=0.58). Catheter complications, analyzed as a secondary end point, were more common in the intravenous group (9.4% vs. 1.0%).

CONCLUSIONS:

Oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first 6 weeks for complex orthopedic infection, as assessed by treatment failure at 1 year. (Funded by the National Institute for Health Research; OVIVA Current Controlled Trials number, ISRCTN91566927 .).
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas Infecciosas / Administração Oral / Artropatias / Antibacterianos Tipo de estudo: Clinical_trials / Guideline Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: N Engl J Med Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas Infecciosas / Administração Oral / Artropatias / Antibacterianos Tipo de estudo: Clinical_trials / Guideline Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: N Engl J Med Ano de publicação: 2019 Tipo de documento: Article