Trends in the treatment of orthopaedic prosthetic infections.
The most commonly used therapy for prosthetic joint infection is a two-stage prosthetic exchange separated by 6 weeks of intravenous antibiotic therapy. This often results in long periods of hospitalization, morbidity, severe functional impairment and sometimes increased mortality. Therefore novel and challenging therapeutic approaches have been attempted, particularly in hip prosthetic infection. This includes, whenever possible, according to the type of microorganism, antibacterial susceptibility and clinical presentation (including age and comorbidities): (i) less aggressive surgical techniques (debridement and prosthesis retention, or re-implantation with a single-stage exchange arthroplasty); and (ii) antibiotic combinations active against biofilm-associated bacteria, including rifampicin (particularly with quinolones) with excellent bio-availability which allow prolonged and efficient oral therapy.
Bernard
Louis
L
Orthopaedic Clinic, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
Hoffmeyer
Pierre
P
Assal
Mathieu
M
Vaudaux
Pierre
P
Schrenzel
Jacques
J
Lew
Daniel
D
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement; D002986:Clinical Trials as Topic; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D012086:Reoperation
D000900:Anti-Bacterial Agents