Treatment approaches to prosthetic joint infections: results of an Emerging Infections Network survey.
We report the results of an Emerging Infections Network survey of 994 infectious disease consultants (IDCs) regarding their participation in the medical management of prosthetic joint infections and observations of adverse effects associated with antibiotic-impregnated materials (response rate, 54.8%). There was general agreement about when a prosthesis can be retained, but substantial variability in the duration of suppressive antibiotics was recommended, with 36% supporting life-long suppression. For 2-stage procedures, 95% recommended a minimum of 4 weeks of systemic antibiotics after the first stage. However, there was little agreement regarding the duration of an antibiotic-free period before reimplantation. Eleven percent of IDCs reported adverse events related to antibiotic-impregnated materials, ranging from skin reactions to renal failure. Further studies to address the substantial variability in the duration of antibiotic suppressive therapy for retained joints and for the duration of antibiotic-free period before reimplantation are needed.
Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA. birgir-johannsson@uiowa.edu
Birgir
B
Johannsson
James
J
Taylor
Charles R
CR
Clark
Hala
H
Shamsuddin
Susan E
SE
Beekmann
Philip
P
Polgreen
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D015331:Cohort Studies; D004337:Drug Carriers / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007595:Joint Prosthesis / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000517:prevention & control; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D004337:Drug Carriers