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      No differences in outcomes with stopping or continuing antibiotic suppression in periprosthetic joint infections

      brief-report

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          Abstract

          The data on long-term antibiotic use following debridement, antibiotics, and implant retention (DAIR) for treatment of periprosthetic joint infections are limited. In this single-center retrospective study, we show that patients with eventual cessation of antibiotic suppression after DAIR had similar outcomes to those who remained on chronic antibiotic suppression.

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          The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria

          Noam Shohat, Karan Goswami, Javad Parvizi … (2018)
          Article 0 comments Cited 459 times – based on 0 reviews     Review now
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            Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America.

            D R Osmon, E F Berbari, A Berendt … (2012)
            These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.
            Article 0 comments Cited 345 times – based on 0 reviews     Review now
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              One hundred and twelve infected arthroplasties treated with ‘DAIR’ (debridement, antibiotics and implant retention): antibiotic duration and outcome

              I Byren, P. Bejon, B L Atkins … (2009)
              Objectives We describe treatment failure rates by antibiotic duration for prosthetic joint infection (PJI) managed with debridement, antibiotics and implant retention (DAIR). Methods We retrospectively collected data from all the cases of PJI that were managed with DAIR over a 5 year period. Surgical debridement, microbiological sampling, early intravenous antibiotics and prolonged oral follow-on antibiotics were used. Results One hundred and twelve cases of PJI were identified. Twenty infections (18%) recurred during a mean follow-up of 2.3 years. The mean duration of antibiotic use was 1.5 years. Failure was more common after arthroscopic debridement, for previously revised joints and for Staphylococcus aureus infection. There were 12 failures after stopping antibiotics and 8 while on antibiotics [hazard ratio (HR) = 4.3, 95% confidence interval (CI) 1.4–12.8, P = 0.01]. However, during the first 3 months of follow-up, there were eight failures after stopping antibiotics and two while on antibiotics (HR = 7.0, 95% CI 1.5–33, P = 0.015). The duration of antibiotic therapy prior to stopping did not predict outcome. Conclusions PJI may be managed by DAIR. The risk of failure with this strategy rises after stopping oral antibiotics, but lengthening antibiotic therapy may simply postpone, rather than prevent, failure.
              Article 0 comments Cited 107 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Daisuke Furukawa
                Journal
                Journal ID (nlm-ta): J Bone Jt Infect
                Journal ID (iso-abbrev): J Bone Jt Infect
                Journal ID (publisher-id): JBJI
                Title: Journal of Bone and Joint Infection
                Publisher: Copernicus GmbH
                ISSN (Electronic): 2206-3552
                Publication date (Electronic): 14 May 2024
                Publication date Collection: 2024
                Volume: 9
                Issue: 3
                Pages: 143-148
                Affiliations
                [1 ] Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California 94304, USA
                [2 ] Quantitative Sciences Unit, Stanford University, Stanford, California 94304, USA
                [3 ] Department of Orthopaedic Surgery, Stanford University, Redwood City, California 94063, USA
                [4 ] Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota 55902, USA
                Author notes
                [*] Correspondence: Daisuke Furukawa ( dfuruk@ 123456stanford.edu )
                Article
                Publisher ID: 01021829
                DOI: 10.5194/jbji-9-143-2024
                PMC ID: 11184613
                PubMed ID: 38899055
                SO-VID: d6d4fb0b-2bd4-4a10-a197-6949f83da211
                Copyright © Copyright: © 2024 Daisuke Furukawa et al.
                License:

                This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

                History
                Date received : 16 December 2023
                Date accepted : 3 April 2024
                Funding
                Funded by: Foundation for the National Institutes of Health (grant nos. R25 AI 147369 and UL1 TR001085)
                Categories
                Subject: Brief Report

                Data availability:

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