Suppressive antibiotic therapy with oral tetracyclines for prosthetic joint infections: a retrospective study of 78 patients
Suppressive antibiotic therapy with oral tetracyclines for prosthetic joint infections: a retrospective study of 78 patients
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DOI：
10.1007/s15010-017-1077-1
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发表时间：
2018-02-01
期刊：
影响因子：
7.5
通讯作者：
Senneville, Eric
中科院分区：
文献类型：
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作者：
Pradier, M.;Robineau, O.;Senneville, Eric
本研究旨在描述口服cyclines（即，多西环素和米诺环素）作为抑制性抗生素治疗（SAT）在假体周围关节感染（PJIs）患者中的应用。78例平均年龄64 ± 17岁的患者在2006年1月至2014年1月期间接受了基于细胞周期素的SAT。PJI累及膝关节37例（47%），髋关节35例（45%），手肘关节4例（5%），肩关节2例（3%），早期合格31例（39.7%）。葡萄球菌属是最常见的病原菌，占细菌总数的72.1%。所有纳入的患者均接受了手术，其中59例（75.6%）进行了清创和种植体保留。分别在72例（92%）和6例（8%）患者中将多西环素和米诺环素作为SAT处方。14例患者（18%）报告了不良事件，其中6例（8%）导致SAT停药。在平均随访1020 +/- 597天后，共有22例（28.2%）患者失败，其中3例（3.8%）记录了初始病原体对四环素的耐药性。我们的研究结果表明，PJI治疗患者使用口服四环素类药物作为SAT具有可接受的耐受性和有效性，在这种情况下似乎是一个合理的选择。
This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs).Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed.Seventy-eight patients of mean age 64 +/- 17 years received cycline-base SAT in the period from January 2006 to January 2014. PJIs involved the knee in 37 patients (47%), the hip in 35 (45%), the elbow in 4 (5%), and the shoulder in 2 (3%) and were qualified as early in 31 patients (39.7%). Staphylococcus spp. were the most common pathogens accounting for 72.1% of the total number of bacterial strains identified. All included patients had surgery which consisted in debridement and implant retention in 59 of them (75.6%). Doxycycline and minocycline were prescribed as SAT in 72 (92%) and 6 (8%) patients, respectively. Adverse events were reported in 14 patients (18%), leading to SAT discontinuation in 6 of them (8%). After a mean follow-up of 1020 +/- 597 days, a total of 22 (28.2%) patients had failed including 3 cases (3.8%) with documented acquisition of tetracycline resistance in initial pathogen(s).Our results suggest that oral cyclines used as SAT in patients treated for PJI have an acceptable tolerability and effectiveness and appear to be a reasonable option in this setting.