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Journal article
Current management of prosthetic joint infections in adults: results of an Emerging Infections Network survey
International journal of antimicrobial agents, v 41(3)
01 Mar 2013
PMID: 23312602
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
There is a dearth of guidance on the management of prosthetic joint infections (PJIs), in particular because of the lack of high-quality evidence for optimal antibiotics. Thus, we designed a nine-question survey of current practices and preferences among members of the Emerging Infections Network, a CDC-sponsored network of infectious diseases physicians, which was distributed in May 2012. In total, 556 (47.2%) of 1178 network members responded. As first-line antibiotic choice for MSSA PJI, 59% of responders indicated oxacillin/nafcillin, 33% cefazolin and 7% ceftriaxone; the commonest alternative was cefazolin (46%). For MRSA PJI, 90% preferred vancomycin, 7% daptomycin and 0.8% ceftaroline; the commonest alternative was daptomycin (65%). Antibiotic selection for coagulase-negative staphylococci varied depending on methicillin susceptibility. For staphylococcal PJIs with retained hardware, most providers would add rifampicin. Propionibacterium is usually treated with vancomycin (40%), penicillin (23%) or ceftriaxone (17%). Most responders thought 10-19% of all PJIs were culture-negative. Culture-negative PJIs of the lower extremities are usually treated with a vancomycin/fluoroquinolone combination, and culture-negative shoulder PJIs with vancomycin/ceftriaxone. The most cited criteria for selecting antibiotics were ease of administration and the safety profile. A treatment duration of 6-8 weeks is preferred (by 77% of responders) and is mostly guided by clinical response and inflammatory markers. Ninety-nine percent of responders recommend oral antibiotic suppression (for varying durations) in patients with retained hardware. In conclusion, there is considerable variation in treatment of PJIs both with identified pathogens and those with negative cultures. Future studies should aim to identify optimum treatment strategies. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
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Details
- Title
- Current management of prosthetic joint infections in adults: results of an Emerging Infections Network survey
- Creators
- Jonas Marschall - Washington University in St. LouisMichael A. Lane - Washington University in St. LouisSusan E. Beekmann - Roy J. and Lucille A. Carver College of MedicinePhilip M. Polgreen - Roy J. and Lucille A. Carver College of MedicineHilary M. Babcock - Washington University in St. Louis
- Publication Details
- International journal of antimicrobial agents, v 41(3)
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- KM1CA156708 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) KL2RR024994 / National Center for Research Resources of the National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) UL1 TR000448; KL2 TR000450; TL1 TR000449 / Clinical and Translational Science Award (CTSA) programme of NCATS at the NIH 5U54CK000162 / CDC Prevention Epicenters Program; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA KL2TR000450 / National Center for Advancing Translational Sciences (NCATS) of the NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) 5U54CK000162 / US Centers for Disease Control and Prevention (CDC) Prevention Epicenters Program Barnes-Jewish Hospital Patient Safety & Quality Fellowship Program UL1TR000448 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) KM1CA156708-01 / National Cancer Institute (NCI) at the NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) 5U50CK000187 / CDC Emerging Infections Network KL2RR024994 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurobiology and Anatomy
- Web of Science ID
- WOS:000314630100011
- Scopus ID
- 2-s2.0-84872934459
- Other Identifier
- 991019298818804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Microbiology
- Pharmacology & Pharmacy