Gram-negative prosthetic joint infections managed according to a multidisciplinary standardized approach: risk factors for failure and outcome with and without fluoroquinolones.
In: Journal of Antimicrobial Chemotherapy (JAC), Jg. 71 (2016-09-01), Heft 9, S. 2593-2597
Online
academicJournal
Zugriff:
Objectives: To describe the outcome and risk factors for treatment failure of 76 Gram-negative bacilli (GNB) prosthetic joint infections (PJIs) managed with a curative intent according to a standardized protocol derived from published guidelines. Methods: We analysed data from all the cases of GNB-PJI treated surgically over an 8 year period. Treatment failure was defined as persistence or recurrence of PJI signs during follow-up, resulting in additional surgery and/or antibiotic administration or death. Results: Treatment failure within the follow-up period (median = 2.6 years) was observed in 16 of 76 (21.1%) patients. The failure rate was similar whether the patients were treated with fluoroquinolones in the whole cohort (22.4% versus 16.7%, P = 0.75) and after stratification according to the surgical procedure. The low failure rate observed in patients not receiving fluoroquinolones might be explained by the standardized attitude of maintaining intravenous β-lactams throughout treatment duration (median = 90 days). In multivariate analysis, C-reactive protein level ≥175 mg/L was significantly associated with treatment failure (adjusted HR = 7.75, 95% CI = 2.66-22.59, P < 0.0001). Conclusions: Management according to standardized procedures may improve the prognosis of GNB-PJI. Intravenous β-lactams, continued for 3 months, should be considered an effective alternative to fluoroquinolones. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Antimicrobial Chemotherapy (JAC) is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Gram-negative prosthetic joint infections managed according to a multidisciplinary standardized approach: risk factors for failure and outcome with and without fluoroquinolones.
|
---|---|
Autor/in / Beteiligte Person: | Grossi, O. ; Asseray, N. ; Bourigault, C. ; Corvec, S. ; Valette, M. ; Navas, D. ; Happi-Djeukou, L. ; Touchais, S. ; Bémer, P. ; Boutoille, D. ; Nantes Bone and Joint Infections Study Group |
Link: | |
Zeitschrift: | Journal of Antimicrobial Chemotherapy (JAC), Jg. 71 (2016-09-01), Heft 9, S. 2593-2597 |
Veröffentlichung: | 2016 |
Medientyp: | academicJournal |
ISSN: | 0305-7453 (print) |
DOI: | 10.1093/jac/dkw202 |
Schlagwort: |
|
Sonstiges: |
|