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Trends in the treatment of orthopaedic prosthetic infections

Bernard, Louis ; Hoffmeyer, Pierre ; Assal, Mathieu ; Vaudaux, Pierre ; Schrenzel, Jacques ; Lew, Daniel

In: Journal of Antimicrobial Chemotherapy, 2004, vol. 53, no. 2, p. 127-129

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    Title
    • Trends in the treatment of orthopaedic prosthetic infections
    Author
    • Bernard, Louis. Orthopaedic Clinic and
    • Hoffmeyer, Pierre. Orthopaedic Clinic and
    • Assal, Mathieu. Orthopaedic Clinic and
    • Vaudaux, Pierre. Division of Infectious Diseases, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland
    • Schrenzel, Jacques. Division of Infectious Diseases, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland
    • Lew, Daniel. Division of Infectious Diseases, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Journal of Antimicrobial Chemotherapy, 2004, vol. 53, no. 2, p. 127-129. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:299584
    Summary
    The most commonly used therapy for prosthetic joint infection is a two-stage prosthetic exchange separated by 6 weeks of intravenous antibiotic therapy. This often results in long periods of hospitalization, morbidity, severe functional impairment and sometimes increased mortality. Therefore novel and challenging therapeutic approaches have been attempted, particularly in hip prosthetic infection. This includes, whenever possible, according to the type of microorganism, antibacterial susceptibility and clinical presentation (including age and comorbidities): (i) less aggressive surgical techniques (debridement and prosthesis retention, or re-implantation with a single-stage exchange arthroplasty); and (ii) antibiotic combinations active against biofilm-associated bacteria, including rifampicin (particularly with quinolones) with excellent bio-availability which allow prolonged and efficient oral therapy