[Management of bone and joint infections: update]

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Bone and joint infections (BJI) are challenging clinical conditions requiring effective management strategies.
• Current treatment paradigms for BJI involve prolonged antibiotic courses, often with significant side effects and healthcare costs.

Purpose of the Study:

• To review recent advancements in the management of bone and joint infections.
• To evaluate the efficacy of different therapeutic approaches, including oral vs. intravenous antibiotics, varying treatment durations, and novel therapies like phage therapy.

Main Methods:

• Review of recent clinical studies and guidelines concerning BJI management.
• Analysis of comparative studies on antibiotic administration routes and treatment durations.
• Assessment of emerging therapeutic options for complex cases.

Main Results:

• Oral antimicrobial therapy demonstrates comparable efficacy to intravenous therapy in the initial six weeks of BJI treatment.
• A randomized controlled study indicated that 6 weeks of antibiotic therapy is not non-inferior to 12 weeks for periprosthetic joint infections.
• A 3-week antibiotic course for diabetic foot osteomyelitis appears non-inferior to a 6-week course.
• Phage therapy presents a promising adjunctive treatment for complicated BJI.

Conclusions:

• Optimizing antibiotic administration and duration can lead to effective BJI management.
• Shorter treatment regimens may be feasible for specific BJI types, such as diabetic foot osteomyelitis.
• Phage therapy offers a novel and promising avenue for managing complex and refractory bone and joint infections.