Short parenteral antibiotic treatment for adult septic arthritis after successful drainage
| Autor: | Jorge Garbino, Ilker Uçkay, Louis Bernard, Domizio Suva, Luisa Tovmirzaeva, Peter Rohner, Daniel Pablo Lew, Pierre Hoffmeyer, Mathieu Assal, Phedon Tahintzi |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_treatment Antibiotics Arthritis Arthritis Infectious/drug therapy/epidemiology/microbiology/therapy Secondary Prevention Infusions Parenteral Prospective cohort study ddc:616 Arthrotomy ddc:617 General Medicine Middle Aged Functional outcome Recurrence/prevention & control Anti-Bacterial Agents Treatment Outcome Infectious Diseases Gram-Negative Bacteria/drug effects Drainage Female Adult Microbiology (medical) medicine.medical_specialty medicine.drug_class Anti-Bacterial Agents/administration & dosage/therapeutic use Gram-Positive Bacteria Drug Administration Schedule Gram-Positive Bacteria/drug effects Parenteral Internal medicine Gram-Negative Bacteria medicine Humans Aged Retrospective Studies Arthritis Infectious business.industry Retrospective cohort study Odds ratio bacterial infections and mycoses medicine.disease Antibiotic treatment Surgery Intravenous therapy Drainage/methods Septic arthritis business |
| Zdroj: | International Journal of Infectious Diseases, Vol. 17, No 3 (2013) pp. e199-205 |
| ISSN: | 1201-9712 |
| DOI: | 10.1016/j.ijid.2011.12.019 |
| Popis: | Summary Objectives To assess the risk factors for recurrence of septic arthritis with an emphasis on the duration of antibiotic treatment, to gather data for a prospective study on an optimized antibiotic treatment in adults with septic arthritis. Methods This was a retrospective single-center study conducted for the period 1996–2008. Results A total of 169 episodes of septic arthritis in 157 adult patients (median age 63 years; 65 females) were included. In 21 episodes (21/169, 12%), arthritis recurred after the end of antibiotic treatment. Multivariate analysis showed that Gram-negative infection (odds ratio (OR) 5.9, 95% confidence interval (CI) 1.4–25.3), immune suppression (OR 5.3, 95% CI 1.3–22.0), and lack of surgical intervention were associated with recurrence. The size of the infected joint, the number of surgical drainages (OR 1.3, 95% CI 1.0–1.7), arthrotomy vs. arthroscopic drainage (OR 0.5, 95% CI 0.2–1.8), duration of antibiotic therapy (OR 1.0, 95% CI 0.95–1.05), and duration of intravenous antibiotic therapy (OR 1.0, 95% CI 1.0–1.0) were not. Seven days of intravenous therapy had the same success rate as 8–21 days (OR 0.4, 95% CI 0.1–1.7) and >21 days (OR 1.1, 95% CI 0.4–3.1). Fourteen days or less of total antibiotic treatment had the same outcome as 15–28 days (OR 0.4, 95% CI 0.1–2.3) or >28 days (OR 0.4, 95% CI 0.1–1.6). Conclusions In this retrospective study of adults with septic arthritis, the duration of antibiotic therapy, or an early switch from intravenous to oral administration, did not statistically influence the risk of recurrence. Due to study limitations, the data cannot be used directly for antibiotic therapy recommendations for septic arthritis. Prospective randomized trials are warranted to optimize the antibiotic treatment of septic arthritis. |
| Databáze: | OpenAIRE |
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