title: Short parenteral antibiotic treatment for adult septic arthritis after successful drainage.
abstract: OBJECTIVE
  To assess the risk factors for recurrence of septic arthritis with an emphasis on the duration of antibiotic treatment, to gather data for a prospective study on an optimized antibiotic treatment in adults with septic arthritis.
  
  
  METHODS
  This was a retrospective single-center study conducted for the period 1996-2008.
  
  
  RESULTS
  A total of 169 episodes of septic arthritis in 157 adult patients (median age 63 years; 65 females) were included. In 21 episodes (21/169, 12%), arthritis recurred after the end of antibiotic treatment. Multivariate analysis showed that Gram-negative infection (odds ratio (OR) 5.9, 95% confidence interval (CI) 1.4-25.3), immune suppression (OR 5.3, 95% CI 1.3-22.0), and lack of surgical intervention were associated with recurrence. The size of the infected joint, the number of surgical drainages (OR 1.3, 95% CI 1.0-1.7), arthrotomy vs. arthroscopic drainage (OR 0.5, 95% CI 0.2-1.8), duration of antibiotic therapy (OR 1.0, 95% CI 0.95-1.05), and duration of intravenous antibiotic therapy (OR 1.0, 95% CI 1.0-1.0) were not. Seven days of intravenous therapy had the same success rate as 8-21 days (OR 0.4, 95% CI 0.1-1.7) and >21 days (OR 1.1, 95% CI 0.4-3.1). Fourteen days or less of total antibiotic treatment had the same outcome as 15-28 days (OR 0.4, 95% CI 0.1-2.3) or >28 days (OR 0.4, 95% CI 0.1-1.6).
  
  
  CONCLUSIONS
  In this retrospective study of adults with septic arthritis, the duration of antibiotic therapy, or an early switch from intravenous to oral administration, did not statistically influence the risk of recurrence. Due to study limitations, the data cannot be used directly for antibiotic therapy recommendations for septic arthritis. Prospective randomized trials are warranted to optimize the antibiotic treatment of septic arthritis.
authors.affiliation: Orthopedic Surgery Service, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4, Rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland. Ilker.Uckay@hcuge.ch
authors.forename: Ilker
authors.initials: I
authors.lastname: Uçkay
authors.forename: Luisa
authors.initials: L
authors.lastname: Tovmirzaeva
authors.forename: Jorge
authors.initials: J
authors.lastname: Garbino
authors.forename: Peter
authors.initials: P
authors.lastname: Rohner
authors.forename: Phedon
authors.initials: P
authors.lastname: Tahintzi
authors.forename: Domizio
authors.initials: D
authors.lastname: Suvà
authors.forename: Mathieu
authors.initials: M
authors.lastname: Assal
authors.forename: Pierre
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: Louis
authors.initials: L
authors.lastname: Bernard
authors.forename: Daniel
authors.initials: D
authors.lastname: Lew
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D004322:Drainage / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents