Is there a role for extended antibiotic therapy in a two-stage revision of the infected knee arthroplasty?
All major studies have incorporated the use of prolonged courses of parenteral or oral antibiotic therapy in the management of two-stage revision of an infected total knee arthroplasty. We present a series of 59 consecutive patients, all with microbiologically-proven deep infection of a total knee arthroplasty, in whom a prolonged course of antibiotic therapy was not routinely used. The mean follow-up was 56.4 months (24 to 114). Of the 38 patients who underwent a staged exchange, infection was successfully eradicated in 34 (89%) but recurrent or persistent infection was present in four (11%). Our rate of cure for infection is similar to that reported elsewhere. We conclude that a prolonged course of antibiotic therapy seems not to alter the incidence of recurrent or persistent infection. The costs of the administration of antibiotics are high and such a regime may be unnecessary.
Hoad-Reddick
D A
DA
Sheffield Teaching Hospitals Trust, Sheffield, England.
Evans
C R
CR
Norman
P
P
Stockley
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002444:Cefuroxime / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002444:Cefuroxime