Fully oral targeted antibiotic therapy for Gram-positive cocci-related periprosthetic joint infections: a real-life before and after study
Autor: | Olivier Robineau, Eric Senneville, Marie Titecat, Eric Beltrand, Hervé Dezèque, N. Blondiaux, Henri Migaud, Alexandre Coehlo, Caroline Loïez, Sophie Putman, Pierre Patoz |
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Rok vydání: | 2021 |
Předmět: |
Microbiology (medical)
medicine.medical_specialty medicine.drug_class medicine.medical_treatment Antibiotics Periprosthetic Administration Oral Targeted therapy Internal medicine Antibiotic therapy medicine Humans Pharmacology (medical) Gram-Positive Cocci Pharmacology business.industry medicine.disease Comorbidity Bioavailability Anti-Bacterial Agents Infectious Diseases Administration Intravenous Rifampin business Rifampicin medicine.drug |
Zdroj: | The Journal of antimicrobial chemotherapy. 76(11) |
ISSN: | 1460-2091 |
Popis: | Background The optimal length of the intravenous antibiotic treatment of periprosthetic joint infections (PJIs) generally ranges from one to six weeks and is a matter of debate. Most antibiotics active against Gram-positive cocci (GPC) exhibit both high oral bioavailability and bone diffusion. Thus, early oral therapy may be a reasonable option in GPC-related PJIs. Methods A 2 year before and after monocentric study that aimed to compare two antibiotic strategies. Empirical intravenous postoperative antibiotic treatment was followed by 7 to 10 days of intravenous targeted therapy (‘before’ group) or by full orally targeted antibiotic treatment (‘after’ group). The primary outcome was a treatment failure during follow-up. Results A total of 93 patients were analysed, 43 and 50 in the before and the after groups, respectively. Both groups were comparable in terms of surgical procedures, comorbidities, microbiological documentation and infection site. Antibiotics prescribed to our patients had high oral bioavailability and bone diffusion with rifampicin/fluoroquinolone combinations being the most frequent antibiotic regimens. Both hospital stay and intravenous antibiotic treatment mean durations were shorter in the before group than in the after group [15.0 versus 11.0 days; (P Conclusions Full oral targeted antibiotic therapy using a drug regimen with high oral bioavailability and good bone diffusion is an option for the treatment of patients with GPC-related PJIs. |
Databáze: | OpenAIRE |
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