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Outpatient Parenteral Antibiotic Therapy (OPAT) with Peripherally Inserted Central Catheter in Patients with

Hinnerk Baecker1, Jan Gessmann1, Yannik Hanusrichter1

  • 1Department of Surgery, BG University Hospital Bergmannsheil, Bochum.

Zeitschrift Fur Orthopadie Und Unfallchirurgie
|August 7, 2019
PubMed
Abstract

Insights

Outpatient intravenous antimicrobial therapy using peripherally inserted central catheters (PICCs) enables early discharge for patients with periprosthetic joint infection. This approach demonstrated a 100% success rate in eradicating difficult-to-treat infections with no observed complications.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Medical Devices

Background:

  • Consistent antimicrobial therapy is crucial for treating periprosthetic joint infection (PJI).
  • Switching to oral antibiotics at discharge risks treatment failure for pathogens requiring intravenous (IV) therapy.
  • Outpatient IV therapy with peripherally inserted central catheters (PICCs) facilitates early discharge while ensuring adequate antimicrobial treatment.

Purpose of the Study:

  • To evaluate the systematic use of PICCs for outpatient IV antimicrobial therapy in patients with PJI.
  • To assess the safety and efficacy of PICCs in managing PJI requiring difficult-to-treat antibiotics.

Main Methods:

  • Prospective evaluation of 11 patients with PJI undergoing treatment with PICCs.
  • Inclusion criteria: pathogen detection requiring IV antibiotics not optimally treatable orally.
  • Analysis of 12 PICCs, focusing on complications and treatment outcomes.

Main Results:

  • No errors or mechanical nerve irritations were observed with PICC use.
  • Zero cases of catheter-related bloodstream infection (CRBSI), PICC-associated infections, thrombophlebitis, or thrombosis.
  • 10 out of 11 patients completed treatment successfully, achieving 100% infection eradication at mean 29-month follow-up.

Conclusions:

  • PICCs are applicable for outpatient IV antimicrobial therapy in PJI treatment.
  • The study observed no catheter-associated complications in the patient collective.
  • Promising results show successful infection control in all cases of difficult-to-treat PJI.

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