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Treatment of acute post-surgical infection of joint arthroplasty

A Soriano1, S García, G Bori

  • 1Department of Infectious Diseases, Hospital Clínic Universitari, IDIBAPS, Barcelona, Spain. asoriano@clinic.ub.es

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|August 3, 2006
PubMed

Insights

Oral antibiotic combinations including rifampicin offer a viable treatment for prosthetic joint infections without implant removal. This approach achieved a 76.9% cure rate in a 2-year study.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Pharmacology

Background:

  • The optimal antibiotic treatment for prosthetic joint infections (PJIs) managed non-surgically remains undefined.
  • Prosthetic joint infections pose significant challenges in orthopedic surgery.
  • Effective non-operative management strategies are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of an oral antibiotic regimen, specifically rifampicin combinations, for treating acute prosthetic joint infections without implant removal.
  • To determine the cure rate and identify risk factors for treatment failure in this patient cohort.

Main Methods:

  • Prospective study of 47 patients with prosthetic joint infections treated with oral antibiotics.
  • Commonly used regimen: levofloxacin (500 mg/24 h) plus rifampicin (600 mg/24 h) for a mean duration of 2.7 months.
  • Follow-up period of 2 years to assess treatment outcomes.

Main Results:

  • A cure rate of 76.9% was achieved with the oral antibiotic protocol.
  • Infection by methicillin-resistant Staphylococcus aureus or Enterococcus spp. was the sole independent risk factor for treatment failure (OR 17.6, p=0.003).
  • The most frequent regimen involved levofloxacin and rifampicin.

Conclusions:

  • Oral antibiotic therapy, particularly rifampicin-based combinations for 2-3 months, represents a favorable treatment option for prosthetic joint infections managed without implant removal.
  • This non-operative approach shows promise, though specific resistant pathogens may impact success.
  • Further research into optimized oral regimens for PJI is warranted.

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