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Recommendations for Systemic Antimicrobial Therapy in Fracture-Related Infection: A Consensus From an International
Melissa Depypere1, Richard Kuehl2, Willem-Jan Metsemakers3
1Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
Journal of Orthopaedic Trauma
|October 1, 2019
Summary
Fracture-related infections (FRIs) are complex due to patient variability. This review provides evidence-based recommendations for systemic antimicrobial therapy in managing FRIs.
Area of Science:
- Orthopaedic surgery
- Infectious diseases
- Musculoskeletal trauma
Background:
- Fracture-related infection (FRI) is a significant complication of musculoskeletal trauma, leading to high morbidity.
- Current treatment strategies for FRI lack standardization due to patient and injury heterogeneity.
- Biofilm formation is central to FRI pathogenesis, making surgical intervention crucial.
Purpose of the Study:
- To summarize current evidence on systemic antimicrobial therapy for FRI.
- To provide expert-opinion-based recommendations for managing FRI-related infections.
- To address the complexities of antimicrobial treatment in diverse FRI cases.
Main Methods:
- Systematic review of recent literature.
- Integration of expert clinical opinion.
- Focus on systemic antimicrobial therapy in the context of surgical management.
Main Results:
- Surgery, including debridement and fixation, is the cornerstone of FRI treatment.
- Systemic antimicrobial therapy is a critical, though sometimes underemphasized, component of FRI management.
- Recommendations are based on the latest evidence and consensus.
Conclusions:
- Standardized systemic antimicrobial therapy protocols are needed for fracture-related infections.
- Effective management requires a comprehensive approach combining surgical expertise and appropriate antibiotic strategies.
- Further research and consensus-building are essential for optimizing FRI treatment outcomes.
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