G. Chieffo , S. Corsia , G. Rougereau , M. Enser , L.J. Eyrolle , S. Kernéis , P. Morand , J. Loubinoux , R. Gauzit , P. Leclerc , P. Wipff , Y. Allanore , P. Anract , D. Salmon
{"title":"一期人工关节置换术后6周抗生素治疗髋关节和膝关节假体周围感染","authors":"G. Chieffo , S. Corsia , G. Rougereau , M. Enser , L.J. Eyrolle , S. Kernéis , P. Morand , J. Loubinoux , R. Gauzit , P. Leclerc , P. Wipff , Y. Allanore , P. Anract , D. Salmon","doi":"10.1016/j.medmal.2020.03.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.</p></div><div><h3>Patients and methods</h3><p>Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-<em>χ</em><sup>2</sup> and Wilcoxon tests were used to compare categorical and continuous variables.</p></div><div><h3>Results</h3><p>Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for <em>Staphylococcus</em> spp. in 29 patients (58%), <em>Cutibacterium acnes</em> in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.</p></div><div><h3>Conclusions</h3><p>A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.</p></div>","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 567-574"},"PeriodicalIF":5.0000,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2020.03.003","citationCount":"5","resultStr":"{\"title\":\"Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection\",\"authors\":\"G. Chieffo , S. Corsia , G. Rougereau , M. Enser , L.J. Eyrolle , S. Kernéis , P. Morand , J. Loubinoux , R. Gauzit , P. Leclerc , P. Wipff , Y. Allanore , P. Anract , D. Salmon\",\"doi\":\"10.1016/j.medmal.2020.03.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.</p></div><div><h3>Patients and methods</h3><p>Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-<em>χ</em><sup>2</sup> and Wilcoxon tests were used to compare categorical and continuous variables.</p></div><div><h3>Results</h3><p>Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for <em>Staphylococcus</em> spp. in 29 patients (58%), <em>Cutibacterium acnes</em> in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.</p></div><div><h3>Conclusions</h3><p>A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.</p></div>\",\"PeriodicalId\":18464,\"journal\":{\"name\":\"Medecine et maladies infectieuses\",\"volume\":\"50 7\",\"pages\":\"Pages 567-574\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2020-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.medmal.2020.03.003\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medecine et maladies infectieuses\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0399077X20300767\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medecine et maladies infectieuses","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0399077X20300767","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection
Objectives
One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.
Patients and methods
Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-χ2 and Wilcoxon tests were used to compare categorical and continuous variables.
Results
Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for Staphylococcus spp. in 29 patients (58%), Cutibacterium acnes in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.
Conclusions
A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.
期刊介绍：
L''organe d''expression de la Société de Pathologie Infectieuse de Langue Française (SPILF).
Médecine et Maladies Infectieuses is the official publication of the Société de Pathologie Infectieuse de Langue Française (SPILF). Médecine et Maladies Infectieuses is indexed in the major databases: Medline, Web of Science/Clarivate and Scopus. The journal publishes scientific /research articles, general reviews, short communications and letters, in both English and French. The journal welcomes submissions on the various aspects of infectious pathologies and pathogenic agents. Médecine et Maladies Infectieuses focuses on clinical therapeutics, nosocomial infections, biology, prevention, as well as epidemiology and therapeutics.
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