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Updated: Aug 1, 2025
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
A single centre experience of prosthetic joint infection outcomes with outpatient parenteral antimicrobial therapy
Abdubadie Kutubi1, Luke O'Brien1, Ben Murphy1
1St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Insights
Outpatient parenteral antimicrobial therapy (OPAT) safely manages prosthetic joint infections (PJIs), showing comparable readmission rates. Type 2 Diabetes Mellitus (T2DM) is linked to higher readmission risks in PJI patients.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Health Economics
Background:
- Prosthetic joint infection (PJI) is a significant complication after arthroplasty.
- Effective management strategies are crucial for patient outcomes and healthcare costs.
Purpose of the Study:
- To evaluate the clinical outcomes of PJIs treated with outpatient parenteral antimicrobial therapy (OPAT).
- To assess readmission rates and the financial impact of OPAT for PJI management.
Main Methods:
- Prospective data collection from an Irish tertiary care hospital (2015-2020).
- Analysis of 41 PJI cases managed with OPAT.
- Statistical analysis using IBM-SPSS to identify risk factors for readmission.
Main Results:
- A 34% hospital readmission rate was observed, comparable to international data.
- Progression of infection was the primary reason for readmission (64.3%).
- Type 2 Diabetes Mellitus (T2DM) showed a significant association with unplanned readmissions (OR 8.5, p < 0.01).
- OPAT resulted in substantial cost savings, averaging 26,505 euros per patient and saving 1,127 hospital bed days.
Conclusions:
- OPAT is a safe and effective management strategy for patients with PJIs.
- Readmissions were mainly due to infection progression, not OPAT complications.
- T2DM is a significant risk factor for readmission in PJI patients undergoing OPAT.
Objectives:
Prosthetic joint infection (PJI) is a serious complication following arthroplasties. This study assessed the clinical outcomes, readmission rates and financial impact of PJIs treated with outpatient parenteral antimicrobial therapy (OPAT).
Methods:
The study used prospectively collected data from the OPAT patient database at a tertiary care Irish hospital for PJI cases managed between 2015 and 2020. Data was analyzed using IBM-SPSS.
Results:
Forty-one patients with PJIs were managed via OPAT over five years, with median age of 71.6 years. Median duration of OPAT was 32 days. Hospital readmission occurred in 34% of cases. Reasons for readmission included progression of infection in 64.3%, unplanned reoperation in 21.4% and planned admission for joint revision in 14.3%. Type 2 Diabetes Mellitus (T2DM) was found to have a statistically significant association with unplanned readmission (OR 8.5, CI 95% 1.1-67.6; p < 0.01). OPAT saved a mean of 27.49 hospital-bed days per patient. 1,127 bed days were saved in total, estimating a total savings of 963,585 euros and median savings of 26,505 euros.
Conclusions:
The readmission rate observed was comparable to international data. Most readmissions were related to primary infections rather than due to OPAT-specific complications. Our main findings were that patients with PJIs can be safely managed via OPAT, and the finding of association between T2DM and increased risk of readmission.
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