Prosthetic joint infections: 6 weeks of oral antibiotics results in a low failure rate.
J Antimicrob Chemother
; 79(2): 327-333, 2024 02 01.
Article
em En
| MEDLINE
| ID: mdl-38113529
ABSTRACT
BACKGROUND:
Need for parenteral administration and total duration of antibiotic therapy for prosthetic joint infection (PJI) are debated. We report our PJI management, in which outpatient care is privileged.METHODS:
This was a retrospective multicentre cohort study of PJI managed from January 2017 to Jun 2021. Microbial diagnosis was based on surgical samples. Surgical procedures and antibiotic treatments were reported. Chronic PJI was defined by a course >1 month. Oral antibiotic therapy (OAT) was defined by exclusive use of oral antibiotics or by ≤3 days of parenteral treatments. Management failure was defined by clinical and/or microbial relapse of PJI over 24 months after surgical treatment.RESULTS:
One hundred and seventy-two patients from 13 institutions were included 103 were male (60%) and mean age was (±SD) 73â±â12 years. Sites for PJI were mainly hip (50%) and knee (35%), being chronic infections in 70 cases (41%). The main bacterial genus in monomicrobial infections was Staphylococcus spp. (60%). We recorded 41 (24%) implant exchanges. An OAT was prescribed in 76 cases (44%), and the median (range) course for parenteral route was 6 days (4-180) for 96 cases. Median (range) duration of antimicrobials was 42 days (21-180). Management failure was observed in 7/76 (9.2%) cases treated with OAT and 15/96 (15.6%) treated with prolonged parenteral therapy. In multivariate analysis, risk factors for failure were a knee PJI [adjusted OR (95% CI)â=â3.27 (1.27-8.40)] and a polymicrobial infection [4.09 (1.46-11.49)].CONCLUSIONS:
OAT for 6 weeks for PJI was associated with a low rate of management failure.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Artrite Infecciosa
/
Infecções Relacionadas à Prótese
Limite:
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article