When It Comes to Antibiotics for Prosthetic Joint Infections, Shorter Is Not Necessarily Better

摘要

Management of prosthetic joint infections (PJI) involves surgery and antimicrobial therapy, although the best approach for each intervention remains unclear. To assess the safety and efficacy of 6 versus 12 weeks of antibiotic therapy for PJI, French investigators conducted a randomized, open-label noninferiority trial. Among 404 participants, 41% had debridement with implant retention, 37% had one-stage implant exchange, and 22% had two-stage implant exchange. The primary pathogens were Staphylococcus aureus (38%, 6-week; 30%, 12-week) and coagulasenegative staphylococci (30%, 6-week; 35%, 12-week). Median duration of intravenous antibiotic therapy was 9 days in both groups whereas median total duration was 42 days (6-week group) and 84 days (12-week group). The most commonly used oral antibiotics were rifampin (70%) and fluoroquinolones (68%).