Complications Associated With Intravenous Antibiotic Treatment for Cutibacterium acnes Periprosthetic Shoulder Infection

Orthopedics ◽  
2021 ◽  
Vol 44 (3) ◽  
Author(s):  
Tyler W. Henry ◽  
Vahid Entezari ◽  
Mohammad Ghoraishian ◽  
Gerald R. Williams ◽  
Surena Namdari
Keyword(s):  
Antibiotic Treatment ◽  
Intravenous Antibiotic ◽  
Cutibacterium Acnes ◽  
Shoulder Infection ◽  
Periprosthetic Shoulder Infection

Prevention of Infection in Adults Receiving Intravenous Antibiotic Treatment via Indwelling Central Venous Access Devices

2019 ◽  
Vol 14 (1) ◽  
pp. 47-49
Author(s):  
Basant K. Puri ◽  
Anne Derham ◽  
Jean A. Monro
Keyword(s):  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Central Venous Access ◽  
Case Series ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Host Cells ◽  
Central Venous ◽  
Intravenous Antibiotic ◽  
Venous Access Devices

Background: The use of indwelling Central Venous Access Devices (CVADs) is associated with the development of bloodstream infections. When CVADs are used to administer systemic antibiotics, particularly second- or higher-generation cephalosporins, there is a particular risk of developing Clostridium difficile infection. The overall bloodstream infection rate is estimated to be around 1.74 per 1000 Central Venous Catheter (CVC)-days. Objective: We hypothesised that daily oral administration of the anion-binding resin colestyramine (cholestyramine) would help prevent infections in those receiving intravenous antibiotic treatment via CVADs. Method: A small case series is described of adult patients who received regular intravenous antibiotic treatment (ceftriaxone, daptomycin or vancomycin) for up to 40 weeks via indwelling CVADs; this represented a total of 357 CVC-days. In addition to following well-established strategies to prevent C. difficile infection, during the course of the intravenous antibiotic treatment the patients also received daily oral supplementation with 4 g colestyramine. Results: There were no untoward infectious events. In particular, none of the patients developed any symptoms or signs of C. difficile infection, whereas approximately one case of a bloodstream infection would have been expected. Conclusion: It is suggested that oral colestyramine supplementation may help prevent such infection through its ability to bind C. difficile toxin A (TcdA) and C. difficile toxin B (TcdB); these toxins are able to gain entry into host cells through receptor-mediated endocytosis, while anti-toxin antibody responses to TcdA and TcdB have been shown to induce protection against C. difficile infection sequelae.

Diagnosing a periprosthetic shoulder infection: A systematic review

2021 ◽  
Vol 26 ◽  
pp. 58-66
Author(s):  
Julio J. Jauregui ◽  
Andrew Tran ◽  
Samir Kaveeshwar ◽  
Vidushan Nadarajah ◽  
Moiuz W. Chaudhri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Infection ◽  
Periprosthetic Shoulder Infection

scholarly journals Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis

2019 ◽  
Vol 380 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Kasper Iversen ◽  
Nikolaj Ihlemann ◽  
Sabine U. Gill ◽  
Trine Madsen ◽  
Hanne Elming ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Intravenous Antibiotic

Severity of anaemia and association with all-cause mortality in patients with medically managed left-sided endocarditis

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319637
Author(s):  
Mia Marie Pries-Heje ◽  
Rasmus Bo Hasselbalch ◽  
Christoffer Wiingaard ◽  
Emil Loldrup Fosbøl ◽  
Andreas Birkedal Glenthøj ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Mortality Rates ◽  
Severe Anaemia ◽  
Valve Surgery ◽  
Oral Antibiotic ◽  
Intravenous Antibiotic ◽  
All Cause Mortality ◽  
Mild Anaemia ◽  
Multivariable Adjustment

ObjectiveTo assess the prevalence and severity of anaemia in patients with left-sided infective endocarditis (IE) and association with mortality.MethodsIn the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial, 400 patients with IE were randomised to conventional or partial oral antibiotic treatment after stabilisation of infection, showing non-inferiority. Haemoglobin (Hgb) levels were measured at randomisation. Primary outcomes were all-cause mortality after 6 months and 3 years. Patients who underwent valve surgery were excluded due to competing reasons for anaemia.ResultsOut of 400 patients with IE, 248 (mean age 70.6 years (SD 11.1), 62 women (25.0%)) were medically managed; 37 (14.9%) patients had no anaemia, 139 (56.1%) had mild anaemia (Hgb <8.1 mmol/L in men and Hgb <7.5 mmol/L in women and Hgb ≥6.2 mmol/L) and 72 (29.0%) had moderate to severe anaemia (Hgb <6.2 mmol/L). Mortality rates in patients with no anaemia, mild anaemia and moderate to severe anaemia were 2.7%, 3.6% and 15.3% at 6-month follow-up and 13.5%, 20.1% and 34.7% at 3-year follow-up, respectively. Moderate to severe anaemia was associated with higher mortality after 6 months (HR 4.81, 95% CI 1.78 to 13.0, p=0.002) and after 3 years (HR 2.14, 95% CI 1.27 to 3.60, p=0.004) and remained significant after multivariable adjustment.ConclusionModerate to severe anaemia was present in 29% of patients with medically treated IE after stabilisation of infection and was independently associated with higher mortality within the following 3 years. Further investigations are warranted to determine whether intensified treatment of anaemia in patients with IE might improve outcome.

scholarly journals What Is the Diagnostic Accuracy of Alpha-Defensin and Leukocyte Esterase Test in Periprosthetic Shoulder Infection?

2019 ◽  
Vol 477 (7) ◽  
pp. 1712-1718 ◽  
Author(s):  
Niklas Unter Ecker ◽  
Alina Koniker ◽  
Thorsten Gehrke ◽  
Jochen Salber ◽  
Akos Zahar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Shoulder Infection ◽  
Periprosthetic Shoulder Infection

scholarly journals LO52: Predictors of oral antibiotic treatment failure for non-purulent skin and soft tissue infections in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S24-S25 ◽  
Author(s):  
K. Yadav ◽  
K. Suh ◽  
D. Eagles ◽  
J. MacIsaac ◽  
D. Ritchie ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Oral Antibiotic ◽  
Soft Tissue Infections ◽  
Emergency Physicians ◽  
Intravenous Antibiotic ◽  
The Past ◽  
History Of ◽  
Chronic Ulcers ◽  
Mrsa Colonization

Introduction: Current guideline recommendations for optimal management of non-purulent skin and soft tissue infections (SSTIs) are based on expert consensus. There is currently a lack of evidence to guide emergency physicians on when to select oral versus intravenous antibiotic therapy. The primary objective was to identify risk factors associated with oral antibiotic treatment failure. A secondary objective was to describe the epidemiology of adult emergency department (ED) patients with non-purulent SSTIs. Methods: We performed a health records review of adults (age 18 years) with non-purulent SSTIs treated at two tertiary care EDs. Patients were excluded if they had a purulent infection or infected ulcers without surrounding cellulitis. Treatment failure was defined any of the following after a minimum of 48 hours of oral therapy: (i) hospitalization for SSTI; (ii) change in class of oral antibiotic owing to infection progression; or (iii) change to intravenous therapy owing to infection progression. Multivariable logistic regression was used to identify predictors independently associated with the primary outcome of oral antibiotic treatment failure after a minimum of 48 hours of oral therapy. Results: We enrolled 500 patients (mean age 64 years, 279 male (55.8%) and 126 (25.2%) with diabetes) and the hospital admission rate was 29.6%. The majority of patients (70.8%) received at least one intravenous antibiotic dose in the ED. Of 288 patients who had received a minimum of 48 hours of oral antibiotics, there were 85 oral antibiotic treatment failures (29.5%). Tachypnea at triage (odds ratio [OR]=6.31, 95% CI=1.80 to 22.08), chronic ulcers (OR=4.90, 95% CI=1.68 to 14.27), history of MRSA colonization or infection (OR=4.83, 95% CI=1.51 to 15.44), and cellulitis in the past 12 months (OR=2.23, 95% CI=1.01 to 4.96) were independently associated with oral antibiotic treatment failure. Conclusion: This is the first study to evaluate potential predictors of oral antibiotic treatment failure for non-purulent SSTIs in the ED. We observed a high rate of treatment failure and hospitalization. Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection and cellulitis within the past year were independently associated with oral antibiotic treatment failure. Emergency physicians should consider these risk factors when deciding on oral versus intravenous antimicrobial therapy for non-purulent SSTIs being managed as outpatients.

Sign in / Sign up

Export Citation Format

Share Document