Antibiotic Treatment and Timing of Reimplantation

doi:10.1002/jor.22557

Cited by 6 publications

(2 citation statements)

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“…23,24 The authors reported variable multidrug antimicrobial regimens, as summarized in Table 2, as guidelines for the treatment of mycobacterial PJI are currently not available. 4,5,25,26…”

Section: Discussionmentioning

confidence: 99%

“…3 Although infection and treatment of PJIs by mycobacterial species have been described, there are presently no established treatment guidelines for mycobacterial PJIs. 4,5 Given the scarcity of clinical experience in dealing with these organisms, and the predicted increasing incidence of revision knee arthroplasty due to infection, we describe an unusual case of a PJI caused by Mycobacterium abscessus (M. abscessus), which was successfully treated using a combination of antimicrobial therapy and staged reconstruction. The patient provided written informed consent for print and electronic publication of this case report.…”

Section: Take-home Pointsmentioning

confidence: 99%

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Mycobacterium abscessus: A Rare Cause of Periprosthetic Knee Joint Infection

Spanyer¹,

Foster²,

Thum-DiCesare³

et al. 2018

Am J Orthop

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“…23,24 The authors reported variable multidrug antimicrobial regimens, as summarized in Table 2, as guidelines for the treatment of mycobacterial PJI are currently not available. 4,5,25,26…”

Section: Discussionmentioning

confidence: 99%

Section: Take-home Pointsmentioning

confidence: 99%

Mycobacterium abscessus: A Rare Cause of Periprosthetic Knee Joint Infection

Spanyer¹,

Foster²,

Thum-DiCesare³

et al. 2018

Am J Orthop

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Therapie der periprothetischen Infektion

Renner

Perka

Trampuž

et al. 2016

Chirurg

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The increasing number of prosthesis implantations and higher life expectancy lead to a growing number of periprosthetic infections (PPI). Optimal therapy necessitates interdisciplinary coordination of surgical and antimicrobial treatment. Challenges in the treatment are the increased occurrence of resistant pathogens, selection of adequate antimicrobial and surgical treatment strategies, inappropriate pretreatment and comorbidities of patients. Current treatment concepts lead to a high success rate in terms of infection eradication, when correctly applied. The individual expectations and underlying conditions of each patient must be considered when determining the therapy concept. The first step is to distinguish between acute and chronic infections. In acute infections the prosthesis can be retained but chronic infections necessitate a complete exchange of the prosthesis. Complicating factors, such as compromising soft tissue and bone conditions, osteomyelitis and infections caused by difficult-to-treat bacteria should, however, always be treated by a complete exchange of the prosthesis, even for acute infections. The antimicrobial treatment must be tailored to the causative agent, the surgical strategy as well as comorbidities and drug intolerances of the patient. It is important to distinguish between biofilm-active eradication therapy with rifampicin for gram-positive pathogens and quinolones for gram-negative organisms and suppression therapy. This article gives a structured presentation of the therapy algorithm.

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