Title :

Fully oral targeted antibiotic therapy for Gram-positive cocci-related periprosthetic joint infections: a real-life before and after study.

Author(s) :

Coehlo, A. [Auteur]
Robineau, Olivier [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Titecat, Marie [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Blondiaux, Nicolas [Auteur]
Dezeque, H. [Auteur]
Patoz, P. [Auteur]
Loiez, C. [Auteur]
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Beltrand, E. [Auteur]
Migaud, Henri [Auteur]
Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
Marrow Adiposity & Bone Lab [MABLab] - ULR 4490
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Journal title :

Journal of Antimicrobial Chemotherapy

Abbreviated title :

J Antimicrob Chemother

Publication date :

2021-08-21

ISSN :

1460-2091

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background The optimal length of the intravenous antibiotic treatment of periprosthetic joint infections (PJIs) generally ranges from one to six weeks and is a matter of debate. Most antibiotics active against Gram-positive ...
Show more >Background The optimal length of the intravenous antibiotic treatment of periprosthetic joint infections (PJIs) generally ranges from one to six weeks and is a matter of debate. Most antibiotics active against Gram-positive cocci (GPC) exhibit both high oral bioavailability and bone diffusion. Thus, early oral therapy may be a reasonable option in GPC-related PJIs. Methods A 2 year before and after monocentric study that aimed to compare two antibiotic strategies. Empirical intravenous postoperative antibiotic treatment was followed by 7 to 10 days of intravenous targeted therapy (‘before’ group) or by full orally targeted antibiotic treatment (‘after’ group). The primary outcome was a treatment failure during follow-up. Results A total of 93 patients were analysed, 43 and 50 in the before and the after groups, respectively. Both groups were comparable in terms of surgical procedures, comorbidities, microbiological documentation and infection site. Antibiotics prescribed to our patients had high oral bioavailability and bone diffusion with rifampicin/fluoroquinolone combinations being the most frequent antibiotic regimens. Both hospital stay and intravenous antibiotic treatment mean durations were shorter in the before group than in the after group [15.0 versus 11.0 days; (P < 0.01) and 13.0 versus 7.0 days; P < 0.001, respectively]. The remission rate assessed after at least a year of follow-up was comparable in the before and the after groups (hazard ratio = 0.70; 95% CI 0.30–1.58). Conclusions Full oral targeted antibiotic therapy using a drug regimen with high oral bioavailability and good bone diffusion is an option for the treatment of patients with GPC-related PJIs.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• Marrow Adiposity & Bone Lab (MABLab) - ULR 4490
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T06:02:44Z
2023-12-04T15:46:25Z