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Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection.

Abstract：

OBJECTIVES:One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85-92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange. PATIENTS AND METHODS:Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-χ2 and Wilcoxon tests were used to compare categorical and continuous variables. RESULTS:Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5-97.4). Infections occurred after a mean of 36 months (IQR 1-216). Bone biopsy cultures were positive for Staphylococcus spp. in 29 patients (58%), Cutibacterium acnes in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4-45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12-101). Overall remission rate was 90%. CONCLUSIONS:A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.

journal_name

Med Mal Infect

journal_title

Medecine et maladies infectieuses

authors

Chieffo G,Corsia S,Rougereau G,Enser M,Eyrolle LJ,Kernéis S,Morand P,Loubinoux J,Gauzit R,Leclerc P,Wipff P,Allanore Y,Anract P,Salmon D

doi

10.1016/j.medmal.2020.03.003

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

567-574

issue

7

eissn

0399-077X

issn

1769-6690

pii

S0399-077X(20)30076-7

journal_volume

50

pub_type

杂志文章

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