TY - JOUR
T1 - How We Approach Suppressive Antibiotic Therapy Following Debridement, Antibiotics, and Implant Retention for Prosthetic Joint Infection
AU - Cortes-Penfield, Nicolas
AU - Krsak, Martin
AU - Damioli, Laura
AU - Henry, Michael
AU - Seidelman, Jessica
AU - Hewlett, Angela
AU - Certain, Laura
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2024/1/15
Y1 - 2024/1/15
N2 - The optimal treatment of prosthetic joint infection (PJI) remains uncertain. Patients undergoing debridement, antibiotics, and implant retention (DAIR) receive extended antimicrobial treatment, and some experts leave patients at perceived highest risk of relapse on suppressive antibiotic therapy (SAT). In this narrative review, we synthesize the literature concerning the role of SAT to prevent treatment failure following DAIR, attempting to answer 3 key questions: (1) What factors identify patients at highest risk for treatment failure after DAIR (ie, patients with the greatest potential to benefit from SAT), (2) Does SAT reduce the rate of treatment failure after DAIR, and (3) What are the rates of treatment failure and adverse events necessitating treatment discontinuation in patients receiving SAT? We conclude by proposing risk–benefit stratification criteria to guide use of SAT after DAIR for PJI, informed by the limited available literature.
AB - The optimal treatment of prosthetic joint infection (PJI) remains uncertain. Patients undergoing debridement, antibiotics, and implant retention (DAIR) receive extended antimicrobial treatment, and some experts leave patients at perceived highest risk of relapse on suppressive antibiotic therapy (SAT). In this narrative review, we synthesize the literature concerning the role of SAT to prevent treatment failure following DAIR, attempting to answer 3 key questions: (1) What factors identify patients at highest risk for treatment failure after DAIR (ie, patients with the greatest potential to benefit from SAT), (2) Does SAT reduce the rate of treatment failure after DAIR, and (3) What are the rates of treatment failure and adverse events necessitating treatment discontinuation in patients receiving SAT? We conclude by proposing risk–benefit stratification criteria to guide use of SAT after DAIR for PJI, informed by the limited available literature.
KW - DAIR
KW - PJI
KW - antibiotic suppression
KW - prosthetic joint infection
KW - suppressive antibiotic therapy
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U2 - 10.1093/cid/ciad484
DO - 10.1093/cid/ciad484
M3 - Review article
C2 - 37590953
AN - SCOPUS:85183584190
SN - 1058-4838
VL - 78
SP - 188
EP - 198
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -