دورية أكاديمية
Effect of Antibiotic Spacer Dosing on Treatment Success in Two-Stage Exchange for Periprosthetic Joint Infection.
| العنوان: | Effect of Antibiotic Spacer Dosing on Treatment Success in Two-Stage Exchange for Periprosthetic Joint Infection. |
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| المؤلفون: | Warwick HS; From the Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA., Tan TL, Rangwalla K, Shau DN, Barry JJ, Hansen EN |
| المصدر: | Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews [J Am Acad Orthop Surg Glob Res Rev] 2024 Feb 22; Vol. 8 (2). Date of Electronic Publication: 2024 Feb 22 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101724868 Publication Model: eCollection Cited Medium: Internet ISSN: 2474-7661 (Electronic) Linking ISSN: 24747661 NLM ISO Abbreviation: J Am Acad Orthop Surg Glob Res Rev Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Philadelphia, PA] : Wolters Kluwer Health, Inc., [2017]- |
| مواضيع طبية MeSH: | Prosthesis-Related Infections*/drug therapy , Arthritis, Infectious*/chemically induced , Arthritis, Infectious*/drug therapy, Humans ; Anti-Bacterial Agents/therapeutic use ; Vancomycin/therapeutic use ; Bone Cements/therapeutic use ; Treatment Outcome |
| مستخلص: | Introduction: In two-stage exchange for periprosthetic joint infection (PJI), adding antibiotics to cement spacers is the standard of care; however, little is known about optimal dosage. There is emphasis on using >3.6 g of total antibiotic, including ≥2.0 g of vancomycin, per 40 g of cement, but these recommendations lack clinical evidence. We examined whether recommended antibiotic spacer doses affect treatment success. Methods: This was a retrospective review of 202 patients who underwent two-stage exchange for PJI from 2004 to 2020 with at least 1-year follow-up. Patients were separated into high (>3.6 g of total antibiotic per 40 g of cement) and low-dose spacer groups. Primary outcomes were overall and infectious failure. Results: High-dose spacers were used in 80% (162/202) of patients. High-dose spacers had a reduced risk of overall (OR, 0.37; P = 0.024) and infectious (OR, 0.35; P = 0.020) failure for infected primary arthroplasties, but not revisions. In multivariate analysis, vancomycin dose ≥2.0 g decreased the risk of infectious failure (OR, 0.31; P = 0.016), although not overall failure (OR, 0.51; P = 0.147). Conclusion: During two-stage exchange for PJI, spacers with greater than 3.6 g of total antibiotic may reduce overall and infectious failure for infected primary arthroplasties. Furthermore, using at least 2.0 g of vancomycin could independently decrease the risk of infectious failure. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.) |
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| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 6Q205EH1VU (Vancomycin) 0 (Bone Cements) |
| تواريخ الأحداث: | Date Created: 20240222 Date Completed: 20240223 Latest Revision: 20240224 |
| رمز التحديث: | 20240224 |
| مُعرف محوري في PubMed: | PMC10883627 |
| DOI: | e23.00103 |
| PMID: | 38385716 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2474-7661 |
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| DOI: | e23.00103 |