Clinical Outcome of Antibiotic Suppressive Therapy in Patients with a Prosthetic Joint Infection after Hip Replacement
| Autor: | Berend W. Schreurs, Wim H. C. Rijnen, Laura Weerwag, Borg Leijtens, Bart Jan Kullberg |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Prosthetic joint Antibiotics antibiotic suppressive therapy digestive system 03 medical and health sciences fluids and secretions 0302 clinical medicine lcsh:Orthopedic surgery Internal medicine Hip replacement medicine hip replacement Orthopedics and Sports Medicine In patient 030212 general & internal medicine Major complication prosthetic joint infection Doxycycline 030222 orthopedics business.industry Prosthetic joint infection digestive system diseases Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] lcsh:RD701-811 Infectious Diseases Increased risk lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Surgery business Research Paper medicine.drug |
| Zdroj: | Journal of Bone and Joint Infection, 4, 268-276 Journal of Bone and Joint Infection, 4, 6, pp. 268-276 Journal of Bone and Joint Infection Journal of Bone and Joint Infection, Vol 4, Pp 268-276 (2019) |
| ISSN: | 2206-3552 |
| Popis: | Introduction: In Specific cases, curative treatment of a prosthetic joint infection (PJI) cannot be accomplished due to the increased risk of major complications after prosthetic joint revision surgery. In these patients, antibiotic suppressive therapy (AST) is often used to control the infection.Aim: To describe the clinical outcome of patients with a PJI after hip replacement treated with AST.Methods: Patients in which AST for PJI was started between 2006 and 2013, were retrospectively included. Follow-up was continued until October 2018. AST has been defined as treatment with oral antibiotic therapy intended to suppress PJI. Treatment was considered successful in patients without reoperation for PJI or death related to PJI during follow-up.Results: Twenty-three patients were included. The most commonly used antibiotics were doxycycline (n=14) and cotrimoxazole (n=6). The mean duration of AST was 38 months (1-151 months). AST was considered successful in 13 patients (56.5%) after a median follow-up of 33 months. AST was least successful in PJI caused by S. aureus with 80% failures versus 33% in PJI caused by other microorganisms and in patients who had an antibiotic-free period before the start of AST with 83% failures. Two patients ended AST due to side effects.Conclusion: AST can be an alternative treatment in selected patients with a PJI after hip replacement. However, there is a persisting and considerable amount of failures, particularly in PJI caused by S. aureus and in patient with an antibiotic-free period before the start of AST. |
| Databáze: | OpenAIRE |
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