1. Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection.
- Author
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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, and Salmon D
- Subjects
- Adult, Aged, Aged, 80 and over, Bacterial Infections etiology, Female, Humans, Male, Middle Aged, Prosthesis-Related Infections etiology, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Anti-Bacterial Agents administration & dosage, Arthroplasty, Replacement, Hip adverse effects, Arthroplasty, Replacement, Hip methods, Arthroplasty, Replacement, Knee adverse effects, Arthroplasty, Replacement, Knee methods, Bacterial Infections drug therapy, Bacterial Infections surgery, Prosthesis-Related Infections drug therapy, Prosthesis-Related Infections surgery
- 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-χ
2 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., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)- Published
- 2020
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