Efficacy of indefinite chronic oral antimicrobial suppression for prosthetic joint infection in the elderly: a comparative study

July 30, 2017 at 12:54 pm

International Journal of Infectious Diseases July 2017 V.60 N.7 P.57-60

 

  1. Prendki, P. Sergent, A. Barrelet, E. Oziol, E. Beretti, M. Berlioz-Thibal, F. Bouchand, F.A. Dauchy, E. Forestier, G. Gavazzi, C. Ronde-Oustau, J. Stirnemann, A. Dinh

Highlights

  • Antimicrobial suppression appears to be effective for prosthetic joint infection (PJI).
  • Antimicrobial suppression appears safe for PJI.
  • Antimicrobial suppression is an adequate option for elderly patients with PJI.

Background

During prosthetic joint infection (PJI), surgical management is sometimes impossible and indefinite chronic oral antimicrobial suppression (ICOAS) may be the only option. The outcomes of elderly patients who benefited from ICOAS with strictly palliative intent were evaluated.

Methods

A national retrospective cohort study was performed in France, involving patients aged >75 years with a PJI who were managed with planned life-long ICOAS from 2009 to 2014. Patients who experienced an event were compared to those who did not. An event was defined as a composite outcome in patients undergoing ICOAS, including local or systemic progression of the infection, death, or discontinuation of antimicrobial therapy because of an adverse drug reaction.

Results

Twenty-one patients were included, with a median age of 85 years (interquartile range 81–88 years). Eight of the 21 patients experienced an event: one had an adverse drug reaction, three had systemic progression of sepsis, and two had local progression. Two of the 21 patients died. No death was related to ICOAS or infection. There was no significant difference between the population with an event and the population free of an event with regard to demographic, clinical, and microbiological characteristics (p > 0.05).

Conclusions

ICOAS appeared to be an effective and safe option in this cohort.

PDF

http://www.ijidonline.com/article/S1201-9712(17)30144-3/pdf

 

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Entry filed under: Antimicrobianos, Bacterias, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones en seniles, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Infecciones sitio quirurgico, Metodos diagnosticos, Profilaxis Antibiótica en Cirugía - PAC, REPORTS, Resistencia bacteriana, Sepsis.

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