Prosthetic joint infections: single versus combination therapy

Journal of Antimicrobial and Chemotherapy January 2010 V.65 N.1 P.18-23

Abstract

Prosthetic joint replacement is increasingly used to alleviate pain and increase mobility. Bone and joint infections remain a therapeutic dilemma for healthcare providers in all fields. Antimicrobial agents combined with appropriate surgical techniques play a vital role in eradicating infections associated with prosthetic joints. The question still remains whether monotherapy or combination therapy is effective in this situation because there is a paucity of well-defined comparative studies. We reviewed in vitro and in vivo studies evaluating the effectiveness of various antimicrobial agents either as single agents or in combination.

abstract

http://jac.oxfordjournals.org/content/65/1/18.abstract

PDF

http://jac.oxfordjournals.org/content/65/1/18.full.pdf+html

 

Treatment of acute hepatitis C in HIV infection

Journal of Antimicrobial and Chemotherapy January 2010 V.65 N.1 P.4-9

Martin Vogel and Jürgen K. Rockstroh*

Department of Internal Medicine I, Bonn University, Bonn, Germany

*Corresponding author. Tel: +49-228-287-16558; Fax: +49-228-287-15034; E-mail: juergen.rockstroh@ukb.uni-bonn.de

Abstract

Within Europe and recently in theUSAandAustraliaan ongoing epidemic of acute hepatitis C virus (HCV) infections among HIV-positive individuals, mainly men who have sex with men, has been observed. Other concomitant sexually transmitted diseases and sexual practices with a high risk of mucosal trauma and damage have been established as risk factors for sexual transmission. In HIV-positive patients the diagnosis of acute HCV infection may be obscured by delayed anti-HCV antibody seroconversion, and HCV RNA testing may be warranted. It is estimated that up to 85% of HIV-positive patients take a chronic course after acute HCV infection, and early treatment of acute HCV infection within 12 weeks after the presumed date of infection is recommended unless spontaneous clearance of HCV has occurred. A watch and wait strategy for 4–8 weeks after the date of diagnosis with 4 weekly HCV RNA controls may help to distinguish patients who will spontaneously clear acute HCV infection from those who will not. Treatment of acute HCV infection with interferon-based therapy has been shown to be highly efficacious, with sustained virological response rates in between 60% and 70% of HIV-positive individuals. Though data are sparse, controlling treatment response at weeks 4 and 12 may further help to individualize therapy, and patients who have not reached a negative HCV RNA by week 12 may benefit from prolonged treatment beyond 24 weeks.

abstract

http://jac.oxfordjournals.org/content/65/1/4.abstract

PDF

http://jac.oxfordjournals.org/content/65/1/4.full.pdf+html