scholarly journals Suppressive Antibiotic Treatment in Prosthetic Joint Infections: A Perspective

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 743
Author(s):  
Javier Cobo ◽  
Rosa Escudero-Sanchez
Keyword(s):  
Life Expectancy ◽  
Antibiotic Treatment ◽  
Joint Infections ◽  
Published Evidence ◽  
Prosthetic Joint ◽  
Number Of Patients ◽  
Prosthetic Joint Infections ◽  
The Many ◽  
Joint Prostheses ◽  
Complex Matter

The treatment of prosthetic joint infections (PJIs) is a complex matter in which surgical, microbiological and pharmacological aspects must be integrated and, above all, placed in the context of each patient to make the best decision. Sometimes it is not possible to offer curative treatment of the infection, and in other cases, the probability that the surgery performed will be successful is considered very low. Therefore, indefinite administration of antibiotics with the intention of “suppressing” the course of the infection becomes useful. For decades, we had little information about suppressive antibiotic treatment (SAT). However, due to the longer life expectancy and increase in orthopaedic surgeries, an increasing number of patients with infected joint prostheses experience complex situations in which SAT should be considered as an alternative. In the last 5 years, several studies attempting to answer the many questions that arise on this issue have been published. The aim of this publication is to review the latest published evidence on SAT.

scholarly journals Prosthetic joint infection by Bordetella holmesii: Case report and a review of the literature

2020 ◽  
Vol 43 (11) ◽  
pp. 748-750
Author(s):  
Mariana Fernandez-Pittol ◽  
Jordi Bosch ◽  
Laura Morata ◽  
Luis Lozano ◽  
Juan Carlos Martínez Pastor ◽  
...  
Keyword(s):  
Case Report ◽  
Synovial Fluid ◽  
Antibiotic Treatment ◽  
Knee Prosthesis ◽  
Case Reports ◽  
Joint Effusion ◽  
Rrna Gene ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Introduction: Bordetella holmesii is a Gram-negative coccobacillus involved in different infections mostly described in case reports. Prosthetic joint infections in relation to this pathogen are rare. Here, we present the third case of B. holmesii in a patient without anatomical or functional spleen dysfunction. Case report: The patient was a 62-year-old female with a total knee prosthesis implanted in 1997 that required multiple replacements of the femoral component due to aseptic loosening in the past years. The patient was admitted to our hospital for an elective replacement surgery due to new radiological signs of loosening. B. holmesii was isolated from synovial fluid obtained during surgery. The identification was performed by matrix-assisted laser desorption ionization–time of flight mass spectrometry and confirmed by 16S rRNA gene amplification and sequencing. Antibiotic treatment was started but 14 days after surgery the patient presented pain and joint effusion. An arthrocentesis was performed and synovial fluid culture was positive again for B. holmesii. Surgical debridement including polyethylene replacement was performed and antibiotic treatment was continued for 3 months. After a 2-year follow-up period, the patient remained asymptomatic and physical examination showed normal function of the prosthesis. Conclusion: B. holmesii is an uncommon cause of bone and joint infections. This case indicates that this microorganism is a potential pathogen of prosthetic or native arthritis, and it should be considered when cultures are negative and in cases presenting torpid evolution.

scholarly journals Chronic prosthetic joint infections with a draining sinus. Who should receive suppressive antibiotic treatment?

2020 ◽  
Vol 6 (2) ◽  
pp. 43-45
Author(s):  
Karel-Jan Lensen ◽  
Rosa Escudero-Sanchez ◽  
Javier Cobo ◽  
Alex Soriano ◽  
Marjan Wouthuyzen-Bakker
Keyword(s):  
Antibiotic Treatment ◽  
Patient Group ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Sinus Tract ◽  
Advantages And Disadvantages ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Abstract. The benefit of suppressive antibiotic treatment in inoperable patients with a chronic periprosthetic joint infection and a sinus tract is unknown. Some physicians prefer to just let the sinus drain, while others prefer antibiotic treatment. In this viewpoint article we discuss the advantages and disadvantages of suppressive antibiotic treatment in this particular patient group.

scholarly journals A Real Pain: Diagnostic Quandaries and Septic Arthritis

2017 ◽  
Vol 56 (2) ◽  
Author(s):  
Cristina Costales ◽  
Susan M. Butler-Wu
Keyword(s):  
Septic Arthritis ◽  
Laboratory Tests ◽  
Joint Infection ◽  
Rapid Diagnosis ◽  
Accurate Diagnosis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
The Many ◽  
Future Utility

ABSTRACT Rapid diagnosis and treatment of an infected joint are paramount in preserving orthopedic function. Here, we present a brief review of the many challenges associated with the diagnosis of both septic arthritis and prosthetic joint infections. We also discuss the many laboratory tests currently available to aid in the accurate diagnosis of joint infection, as well as emerging diagnostics that may have future utility in the diagnosis of these challenging clinical entities.

scholarly journals 315. Oral Vs. Intravenous Antibiotic Treatment for Gram-Positive Prosthetic Joint Infections: A Retrospective Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S127-S127
Author(s):  
Alexandre Coehlo ◽  
Olivier Robineau ◽  
Marie Titecat ◽  
Sophie Putman ◽  
Nicolas Blondiaux ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Antibiotic Treatment ◽  
Intravenous Antibiotic ◽  
Gram Positive ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

scholarly journals Daptomycin versus Vancomycin as Post-Operative Empirical Antibiotic Treatment for Prosthetic Joint Infections: A Case-Control Study

2019 ◽  
Vol 4 (2) ◽  
pp. 72-75 ◽  
Author(s):  
C Joseph ◽  
O Robineau ◽  
M Titecat ◽  
S Putman ◽  
N Blondiaux ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Knee Prosthesis ◽  
Empirical Antibiotic Treatment ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
The Mean ◽  
Septic Revision ◽  
Control Study

Abstract. Purpose: To compare safety and efficacy of Vancomycin (Van) versus Daptomycin (Dap) as post-operative empirical antibiotic treatment (PEAT) in patients with periprosthetic joint infections (PJIs).Methods: Medical charts of patients treated empirically with Van or Dap in the post-operative period of total hip/knee prosthesis septic revision until the results of intra-operative culture were reviewed. Cefotaxime, cefepime or aztreonam were used in combination with Dap or Van.Results: Twenty Dap patients were matched with 20 other Van patients according to the age and type of prosthesis. The ASA score and the distribution of the pathogens was similar in the two groups especially regarding the number of methicillin-resistant staphylococci. The mean duration of the PEAT was 6.07 ± 0.85 days. A total of 17 episodes of adverse events (AE) in 10 patients (25%) were recorded during the PEAT which led to discontinue the treatment in 5 patients, all of them treated with Van (P=0.02). At the end of a mean post-treatment follow-up of 618 +/- 219 days, 36 patients remained in remission of infection; 2 patients failed in each group.Conclusions: Our observations suggest that PEAT with Van for septic revision of PJIs is associated with a higher discontinuation rate due to AE but with a similar outcome than it is with Dap.

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