Prolonged suppressive antibiotic therapy for prosthetic joint infection in the elderly: a national multicentre cohort study

2017 ◽  
Vol 36 (9) ◽  
pp. 1577-1585 ◽  
Author(s):  
V. Prendki ◽  
T. Ferry ◽  
P. Sergent ◽  
E. Oziol ◽  
E. Forestier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
The Elderly ◽  
Prosthetic Joint ◽  
Multicentre Cohort Study ◽  
Suppressive Antibiotic Therapy ◽  
Multicentre Cohort

scholarly journals Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study

2020 ◽  
Vol 26 (4) ◽  
pp. 499-505 ◽  
Author(s):  
R. Escudero-Sanchez ◽  
E. Senneville ◽  
M. Digumber ◽  
A. Soriano ◽  
M.D. del Toro ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Therapy ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Multicentre Cohort Study ◽  
Prosthetic Joint Infections ◽  
Suppressive Antibiotic Therapy ◽  
Multicentre Cohort

scholarly journals Subcutaneous suppressive antibiotic therapy for bone and joint infections: safety and outcome in a cohort of 10 patients

2019 ◽  
Vol 74 (7) ◽  
pp. 2060-2064 ◽  
Author(s):  
Cécile Pouderoux ◽  
Agathe Becker ◽  
Sylvain Goutelle ◽  
Sébastien Lustig ◽  
Claire Triffault-Fillit ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Prosthetic Joint Infection ◽  
Salvage Therapy ◽  
Chronic Osteomyelitis ◽  
Joint Infection ◽  
Intensive Therapy ◽  
Treatment Modalities ◽  
Surgical Removal ◽  
Prosthetic Joint ◽  
Suppressive Antibiotic Therapy

Abstract Background Optimal treatment of prosthetic joint infection and chronic osteomyelitis consists of surgical removal of biofilm-embedded bacteria, followed by a 6–12 week course of antimicrobial therapy. However, when optimal surgery is not feasible, oral prolonged suppressive antibiotic therapy (PSAT) is recommended to prevent prosthesis loosening and/or relapse of infection. Since 2010, we have used infection salvage therapy using off-label subcutaneous (sc) injection of a β-lactam as PSAT for patients in whom oral PSAT is not possible. Methods A single-centre prospective cohort study (2010–18) reporting treatment modalities, efficacy and safety in all patients receiving sc PSAT. NCT03403608. Results The 10 included patients (median age 79 years) had polymicrobial (n = 5) or MDR bacterial (n = 4) prosthetic joint infection (knee, n = 4; hip, n = 3) or chronic osteomyelitis (n = 3). After initial intensive therapy, seven patients received ertapenem, three patients received ceftriaxone and one patient received ceftazidime by sc injection (one patient received 8 days of ceftriaxone before receiving ertapenem). In one patient, sc PSAT failed with recurrent signs of infection under treatment. In three patients, sc PSAT had to be discontinued due to side effects; in only one of these was the sc route implicated (skin necrosis following direct sc injection and not gravity infusion). Median treatment duration was 433 days. In six patients, sc PSAT was successful with favourable outcome at the time of writing. Interestingly, three patients with MDR bacterial carriage at baseline lost this under PSAT during follow-up. Conclusions As salvage therapy, sc PSAT delivered by gravity infusion is a safe and interesting alternative when an optimal surgical strategy is not feasible and no oral treatment is available.

Prolonged suppressive antibiotic therapy is successful in the management of prosthetic joint infection

2019 ◽  
Vol 30 (2) ◽  
pp. 313-321 ◽  
Author(s):  
N. A. Sandiford ◽  
J. R. Hutt ◽  
D. O. Kendoff ◽  
P. A. Mitchell ◽  
M. Citak ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Suppressive Antibiotic Therapy

scholarly journals Outcome of patients over 80 years of age on prolonged suppressive antibiotic therapy for at least 6 months for prosthetic joint infection

2014 ◽  
Vol 29 ◽  
pp. 184-189 ◽  
Author(s):  
Virginie Prendki ◽  
Valérie Zeller ◽  
Dorick Passeron ◽  
Nicole Desplaces ◽  
Patrick Mamoudy ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Suppressive Antibiotic Therapy

scholarly journals 4CPS-030 Incidence and risk factors for prosthetic joint infection within 90 days after hemiarthroplasty for femoral neck fractures in the elderly

2020 ◽  
Author(s):  
P Declercq ◽  
L Vanden Broeck ◽  
L Moons ◽  
I Du Bois ◽  
D Scherrenberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Prosthetic Joint

scholarly journals Statin therapy and recurrent venous thromboembolism in the elderly: a prospective cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Regula Monika Kronenberg ◽  
Shanthi Beglinger ◽  
Odile Stalder ◽  
Marie Méan ◽  
Andreas Limacher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Propensity Scores ◽  
The Elderly ◽  
Confounding By Indication ◽  
Multicentre Cohort Study ◽  
Recurrent Venous Thromboembolism ◽  
Reduce Risk ◽  
Multicentre Cohort

Abstract Previous studies reported lower rates of recurrent venous thromboembolism (rVTE) among statin users, but this association could be influenced by concurrent anticoagulation and confounding by statin indication. This study aimed to confirm the beneficial association between statins and rVTE, stratified according to periods with and without anticoagulation, and additionally employ propensity score weighted approach to reduce risk of confounding by indication. The setting was a prospective multicentre cohort study and the outcome was time to first rVTE in statin vs. non-statin users. 980 participants with acute VTE were enrolled (mean age 75.0 years, 47% women), with median follow-up of 2.5 years. Of 241 (24.3%) statin users, 21 (8.7%) suffered rVTE vs. 99 (13.4%) among 739 non-users. The overall adjusted sub-hazard ratio (aSHR) for rVTE comparing statin users to non-users was 0.72 (95%CI 0.44 to 1.19, p = 0.20). This association was only apparent during periods without anticoagulation (aSHR 0.50, 95%CI 0.27 to 0.92, p = 0.03; vs. with anticoagulation: aSHR 1.34, 95%CI 0.54 to 3.35, p = 0.53). Using propensity scores, the rVTE risk during periods without anticoagulation fell further (aSHR 0.20, 95%CI 0.08 to 0.49, p < 0.001). In conclusion, statin use is associated with a more pronounced risk reduction for rVTE than previously estimated, but only during periods without anticoagulation.

scholarly journals Risk of Recurrent Staphylococcus aureus Prosthetic Joint Infection in Rheumatoid Arthritis Patients—A Nationwide Cohort Study

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Namrata Singh ◽  
Rajeshwari Nair ◽  
Michihiko Goto ◽  
Martha L Carvour ◽  
Ryan Carnahan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Prosthetic Joint Infection ◽  
Proportional Hazards ◽  
Joint Infection ◽  
International Classification Of Diseases ◽  
Cox Proportional Hazards ◽  
Prosthetic Joint ◽  
Implant Retention

AbstractBackgroundTreatment of rheumatoid arthritis (RA) often involves immune-suppressive therapies. Concern for recurrent prosthetic joint infection (PJI) in RA patients might be high and could reduce use of joint implantation in these patients. We aimed to evaluate the risk of recurrence of PJI in RA patients compared with osteoarthritis (OA) patients by utilizing a large health care system.MethodsWe conducted a retrospective cohort study of all patients admitted for a Staphylococcus aureus PJI who underwent debridement, antibiotics, and implant retention (DAIR) or 2-stage exchange (2SE) between 2003 and 2010 at 86 Veterans Affairs Medical Centers. Both RA patients and the comparison group of osteoarthritis (OA) patients were identified using International Classification of Diseases, Ninth Revision, codes. All index PJI and recurrent positive cultures for S. aureus during 2 years of follow-up were validated by manual chart review. A Cox proportional hazards regression model was used to compare the time to recurrent PJI for RA vs OA.ResultsIn our final cohort of 374 veterans who had either DAIR or 2SE surgery for their index S. aureus PJI, 11.2% had RA (n = 42). The majority of the cohort was male (97.3%), and 223 (59.6%) had a methicillin-susceptible S. aureus PJI. RA patients had a similar risk of failure compared with OA patients, after adjusting for covariates (hazard ratio, 0.81; 95% confidence interval, 0.48–1.37).ConclusionsPrior diagnosis of RA does not increase the risk of recurrent S. aureus PJI. Further studies are needed to evaluate the effect of different RA therapies on outcomes of episodes of PJI.

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