Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection - 22/09/20
Antibiothérapie de six semaines pour les infections ostéoarticulaires sur prothèse de hanche et genou après reprise totale en un temps
, S. Corsia c, G. Rougereau c, M. Enser d, L.J. Eyrolle d, S. Kernéis a, P. Morand e, J. Loubinoux e, R. Gauzit d, P. Leclerc c, P. Wipff f, Y. Allanore f, P. Anract c, D. Salmon a, ⁎ Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
| pagine | 8 |
| Iconografia | 1 |
| Video | 0 |
| Altro | 0 |
Highlights |
• | Periprosthetic joint infection (PJI) is one of the most serious complications of prosthetic joint implantations with significant morbidity and mortality. |
• | One-stage replacement arthroplasty for the treatment of PJIs results in similar cure rate than two-stage replacement arthroplasty, but the antibiotic therapy duration is not well established. |
• | Recent data reported successful results with a six-week antibiotic therapy for two-stage arthroplasty, while the experience is very limited for one-stage arthroplasty. |
• | We aimed to evaluate the effectiveness of a short six-week antibiotic course in PJIs after one-stage exchange. |
• | A six-week course of antibiotics for knee and hip PJIs treated with one-stage replacement arthroplasty had a satisfactory remission rate. |
Abstract |
Objectives |
One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.
Patients and methods |
Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-χ2 and Wilcoxon tests were used to compare categorical and continuous variables.
Results |
Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for Staphylococcus spp. in 29 patients (58%), Cutibacterium acnes in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.
Conclusions |
A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.
Il testo completo di questo articolo è disponibile in PDF.Résumé |
Objectifs |
La reprise totale de prothèse (RTP) en un temps pour le traitement des infections ostéoarticulaires (IOA) sur prothèse montre des taux de rémission comparables au ceux en deux temps (85–92 %), mais la durée de l’antibiothérapie n’est pas encore bien déterminée. L’étude examinait l’efficacité de six semaines d’antibiothérapie dans les IOA sur prothèse après RTP en un temps.
Patientes et méthodes |
Étude observationnelle rétrospective réalisée dans le service d’orthopédie de l’hôpital Cochin, Paris, entre le 1er janvier 2010 et le 31 décembre 2015. Étaient inclus les patients ayant une IOA sur prothèse, microbiologiquement prouvée, ayant bénéficier d’une RPT et d’une antibiothérapie pour 6 semaines (±1 semaine). Les variables catégorielles et continues étaient comparés respectivement par les tests de Pearson-χ2 et de Wilcoxon.
Résultats |
Cinquante patients porteurs d’une IOA sur prothèse (hanche=42, genou=8) traités par remplacement en un temps ont été inclus. L’âge médian était 69,3 ans (IQR : 24,5–97,4). Le délai moyen de survenue de l’infection était de 36 mois (IQR 1–216). Les principales bactéries identifiées étaient Staphylococcus spp. (58 %), Cutibacterium acnes (38 %), bacilles Gram-négatif (12 %). Il s’agissait d’infections polymicrobiennes dans 24 % des cas. Les antibiotiques étaient administrés par voie intraveineuse pendant en médiane 11jours (IQR 4–45) poursuivis par voie orale chez 46 (92 %) patients. Le suivi médian était 32 mois (IQR 12–101). Le taux de rémission était de 90 %.
Conclusion |
Six semaines d’antibiothérapie dans les IOA sur prothèse après RTP en un temps ont un taux de rémission satisfaisant dans cette étude ouverte.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Replacement arthroplasty, One-stage replacement, Periprosthetic joint infections
Mots clés : Reprise totale de prothèse, Reprise en un temps, Infections ostéoarticulaires sur prothèse
Mappa
Vol 50 - N° 7
P. 567-574 - Ottobre 2020 Ritorno al numero
Articolo precedente
- Ebola virus disease in children in Conakry and Coyah Ebola treatment centers and risk factors associated with death
- M.S. Sow, D.C. Sow, M.L. Diallo, D. Kassé, K. Sylla, A. Camara, S.D. Djiro, M.O.S. Diallo, E.I. Bah, I. Bah, M.P. Diallo
- E-health. Patterns of use and perceived benefits and barriers among people living with HIV and their physicians. Part 1: Information retrieval on the Internet and social networks
- C. Jacomet, P. Bastiani, J. Prouteau, C. Lambert, F. Linard, R. Ologeanu-Taddei, P. Dellamonica
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?