Buscar

Estamos realizando la búsqueda. Por favor, espere...

 Detalle_Publicacion

Suppressive Antibiotic Therapy in Prosthetic Joint Infections: A Multicentre Cohort Study

Abstract: Objectives: The aim was to describe the effectiveness of suppressive antibiotic treatment (SAT) in routine clinical practice when used in situations in which removal of a prosthetic implant is considered essential for the eradication of an infection, and it cannot be performed. Methods: This was a descriptive retrospective and multicentre cohort study of prosthetic joint infection (PJI) cases managed with SAT. SAT was considered to have failed if a fistula appeared or persisted, if debridement was necessary, if the prosthesis was removed due to persistence of the infection or if uncontrolled symptoms were present. Results: In total, 302 patients were analysed. Two hundred and three of these patients (67.2%) received monotherapy. The most commonly used drugs were tetracyclines (39.7% of patients) (120/302) and cotrimoxazole (35.4% of patients) (107/302). SAT was considered successful in 58.6% (177/302) of the patients (median time administered, 36.5 months; IQR 20.75-59.25). Infection was controlled in 50% of patients at 5 years according to Kaplan-Meier analysis. Resistance development was documented in 15 of 65 (23.1%) of the microbiologically documented cases. SAT failure was associated with age <70 years (sub-hazard ratio (SHR) 1.61, 95% CI 1.1-2.33), aetiology other than Gram-positive cocci (SHR 1.56, 95% CI 1.09-2.27) and location of the prosthesis in the upper limb (SHR 2.4, 95% CI 1.5-3.84). SAT suspension was necessary due to adverse effects in 17 of 302 patients (5.6%). Conclusions: SAT offers acceptable results for patients with PJI when surgical treatment is not performed or when it fails to eradicate the infection.

 Fuente: Clin Microbiol Infect . 2020 Apr;26(4):499-505

Editorial: Elsevier

 Fecha de publicación: 01/04/2020

Nº de páginas: 7

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.cmi.2019.09.007

ISSN: 1198-743X,1469-0691

Url de la publicación: https://doi.org/10.1016/j.cmi.2019.09.007

Autores/as

ESCUDERO-SANCHEZ, ROSA

SENNEVILLE, ERIC

DIGUMBER, MARC

SORIANO, ALEX

TORO, M. DOLORES DEL

BAHAMONDE, ALBERTO

POZO, JOSE LUIS DEL

GUIO, LAURA

MURILLO, OSCAR

RICO, ALICIA

GARCÍA-PAÍS, M. JOSE

RODRÍGUEZ-PARDO, DOLORS

IRIBARREN, JOSE ANTONIO

BENITO, NATIVIDAD

FRESCO, GEMA

MURIEL GARCÍA, ALFONSO

ARIZA, JAVIER

COBO, JAVIER