Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study
Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study
复制标题
DOI：
10.1016/j.cmi.2019.09.007
复制
发表时间：
2020-04-01
影响因子：
14.2
通讯作者：
Cobo, J.
中科院分区：
文献类型：
--
作者：
Escudero-Sanchez, R.;Senneville, E.;Cobo, J.
目的：我们的目的是描述抑制性抗生素治疗（SAT）在常规临床实践中使用的情况下，其中去除假体植入物被认为是必不可少的根除感染，它不能performing.Methods：这是一个描述性的回顾性和多中心队列研究的人工关节感染（PJI）的情况下，SAT管理。SAT被认为是失败的，如果瘘出现或持续存在，如果清创是必要的，如果假体被删除，由于持续的感染或如果不受控制的症状present.Results：在总数中，302例进行了分析。其中203例患者（67.2%）接受了单药治疗。最常用的药物是四环素类（39.7%的患者）（120/302）和复方新诺明（35.4%的患者）（107/302）。58.6%（177/302）的患者认为SAT成功（中位给药时间为36.5个月; IQR 20.75-59.25）。根据Kaplan-Meier分析，5年时50%的患者感染得到控制。在65例微生物学记录病例中，15例（23.1%）记录了耐药性发展。SAT失败与年龄有关
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