Effectiveness of early switching from intravenous to oral antibiotic therapy in Staphylococcus aureus prosthetic bone and joint or orthopedic metalware-associated infections

Autor: Pascal Kouyoumdjian, Albert Sotto, J. Crouzet, Hélène Boclé, Jean-Philippe Lavigne, Nicolas Cellier, Paul Loubet
Přispěvatelé: Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Virulence bactérienne et maladies infectieuses (VBMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Malbec, Odile
Rok vydání: 2021
Předmět:
Adult
Male
Methicillin-Resistant Staphylococcus aureus
Staphylococcus aureus
medicine.medical_specialty
Prosthesis-Related Infections
lcsh:Diseases of the musculoskeletal system
Sports medicine
medicine.drug_class
[SDV]Life Sciences [q-bio]
medicine.medical_treatment
Antibiotics
medicine.disease_cause
Intravenous antibiotic treatment
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
Epidemiology
medicine
Humans
Orthopedics and Sports Medicine
Oral antibiotic treatment
030212 general & internal medicine
Retrospective Studies
Prosthetic bone and joint infections
0303 health sciences
030306 microbiology
Proportional hazards model
business.industry
Middle Aged
Staphylococcal Infections
Anti-Bacterial Agents
3. Good health
[SDV] Life Sciences [q-bio]
Intravenous therapy
Orthopedic surgery
Female
lcsh:RC925-935
business
Research Article
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, BioMed Central, 2021, 22 (1), pp.315. ⟨10.1186/s12891-021-04191-y⟩
BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-7 (2021)
ISSN: 1471-2474
Popis: Background The optimal duration of intravenous antibiotic therapy in Staphylococcus aureus prosthetic bone and joint infection has not been established. The objective of this study was to compare the effect of early and late intravenous-to-oral antibiotic switch on treatment failure. Patients and methods We retrospectively analyzed all adult cases of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection between January 2008 and December 2015 in a French university hospital. The primary outcome was treatment failure defined as the recurrence of S. aureus prosthetic bone and joint or orthopedic metalware-associated infection at any time during or after the first line of medical and surgical treatment within 2 years of follow-up. A Cox model was created to assess risk factors for treatment failure. Results Among the 140 patients included, mean age was 60.4 years (SD 20.2), and 66% were male (n = 92). Most infections were due to methicillin-susceptible S. aureus (n = 113, 81%). The mean duration of intravenous antibiotic treatment was 4.1 days (SD 4.6). The majority of patients (119, 85%) had ≤5 days of intravenous therapy. Twelve patients (8.5%) experienced treatment failure. Methicillin-resistant S. aureus infections (HR 11.1; 95% CI 1.5–111.1; p = 0.02), obesity (BMI > 30 kg/m2) (HR 6.9; 95% CI1.4–34.4, p = 0.02) and non-conventional empiric antibiotic therapy (HR 7.1; 95% CI 1.8–25.2; p = 0.005) were significantly associated with treatment failure, whereas duration of intravenous antibiotic therapy (≤ 5 or > 5 days) was not. Conclusion There was a low treatment failure rate in patients with S. aureus prosthetic bone and joint or orthopedic metalware-associated infection with early oral switch from intravenous to oral antibiotic therapy.
Databáze: OpenAIRE
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