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Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study.
Escudero-Sanchez, R; Senneville, E; Digumber, M; Soriano, A; Del Toro, M D; Bahamonde, A; Del Pozo, J L; Guio, L; Murillo, O; Rico, A; García-País, M J; Rodríguez-Pardo, D; Iribarren, J A; Fernández, M; Benito, N; Fresco, G; Muriel, A; Ariza, J; Cobo, J.
Afiliación
  • Escudero-Sanchez R; Hospital Ramón y Cajal, IRYCIS, Madrid, Spain. Electronic address: rosa.escudero0@gmail.com.
  • Senneville E; Centre Hospitalier Gustave Dron, Tourcoing, France.
  • Digumber M; Centre Hospitalier Gustave Dron, Tourcoing, France.
  • Soriano A; Hospital Clinic, Barcelona, Spain.
  • Del Toro MD; Hospital Virgen Macarena, Sevilla, Spain.
  • Bahamonde A; Hospital El Bierzo, León, Spain.
  • Del Pozo JL; Clínica Universitaria Navarra, Navarra, Spain.
  • Guio L; Hospital Cruces, Vizcaya, Spain.
  • Murillo O; Hospital Bellvitge, Barcelona, Spain.
  • Rico A; Hospital Universitario La Paz, Madrid, Spain.
  • García-País MJ; Hospital Lucus Augusti, Lugo, Spain.
  • Rodríguez-Pardo D; Hospital Vall d'Hebron, Barcelona, Spain.
  • Iribarren JA; Hospital de Donostia, Gipuzkoa, Spain.
  • Fernández M; Hospital de Valdecilla, Cantabria, Spain.
  • Benito N; Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • Fresco G; Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
  • Muriel A; Hospital Ramón y Cajal, IRYCIS, CIBER, Madrid, Spain.
  • Ariza J; Hospital Bellvitge, Barcelona, Spain.
  • Cobo J; Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
Clin Microbiol Infect ; 26(4): 499-505, 2020 Apr.
Article en En | MEDLINE | ID: mdl-31539638
OBJECTIVES: The aim was to describe the effectiveness of suppressive antibiotic treatment (SAT) in routine clinical practice when used in situations in which removal of a prosthetic implant is considered essential for the eradication of an infection, and it cannot be performed. METHODS: This was a descriptive retrospective and multicentre cohort study of prosthetic joint infection (PJI) cases managed with SAT. SAT was considered to have failed if a fistula appeared or persisted, if debridement was necessary, if the prosthesis was removed due to persistence of the infection or if uncontrolled symptoms were present. RESULTS: In total, 302 patients were analysed. Two hundred and three of these patients (67.2%) received monotherapy. The most commonly used drugs were tetracyclines (39.7% of patients) (120/302) and cotrimoxazole (35.4% of patients) (107/302). SAT was considered successful in 58.6% (177/302) of the patients (median time administered, 36.5 months; IQR 20.75-59.25). Infection was controlled in 50% of patients at 5 years according to Kaplan-Meier analysis. Resistance development was documented in 15 of 65 (23.1%) of the microbiologically documented cases. SAT failure was associated with age <70 years (sub-hazard ratio (SHR) 1.61, 95% CI 1.1-2.33), aetiology other than Gram-positive cocci (SHR 1.56, 95% CI 1.09-2.27) and location of the prosthesis in the upper limb (SHR 2.4, 95% CI 1.5-3.84). SAT suspension was necessary due to adverse effects in 17 of 302 patients (5.6%). CONCLUSIONS: SAT offers acceptable results for patients with PJI when surgical treatment is not performed or when it fails to eradicate the infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bacterias / Infecciones Relacionadas con Prótesis / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bacterias / Infecciones Relacionadas con Prótesis / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido