- Title
- Global practice variation of suppressive antimicrobial treatment for prosthetic joint infections: A cross-sectional survey study
- Creator
- Hanssen, Jaap L. J.; Gademan, Maaike G. J.; van der Linden, Henrica M. J.; Cortés-Penfield, Nicolás W.; Soriano, Alex; de Boer, Mark G. J.; Scheper, Henk; Wouthuyzen-Bakker, Marjan; Davis, Joshua S.; Dewar, David; Manning, Laurens; Campbell, David; van Prehn, Joffrey; Miller, Andy O.; van der Wal, Robert J. P.
- Relation
- Journal of Infection Vol. 89, Issue 6, no. 106316
- Publisher Link
- http://dx.doi.org/10.1016/j.jinf.2024.106316
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2024
- Description
- Objectives: To identify global differences in the use of suppressive antimicrobial therapy (SAT) in the management of prosthetic joint infection (PJI). Methods: An online survey was designed to investigate clinician's approach to SAT for PJI, including indications, preferred antimicrobial drugs, dosing, treatment duration and follow-up. The survey was distributed to members of four international (bone and joint) infection societies and study groups. Results: Respondents comprised 330 physicians (204 infectious diseases specialists, 110 orthopedic surgeons, 23 clinical microbiologists) from 43 different countries (Europe, n = 134, 41%; Oceania n = 112, 34%; North America, n = 51, 16%; other, n = 33, 10%; total response rate 20%). After debridement, antibiotics and implant retention (DAIR) or one-stage revision, SAT would be initiated often or almost always by 38% of respondents from North America, but only in 6% from Europe and 7% from Oceania. First choices of SAT for staphylococcal PJI were oral cephalosporins (39%) and tetracyclines (31%) in North America; tetracyclines (27%) and anti-staphylococcal penicillins (22%) in Europe; and anti-staphylococcal penicillins (55%) in Oceania. There was no global or regional preferred SAT regimen for Gram-negative PJI. Of all respondents, dosage of SAT was never lowered (n = 126, 38%), lowered for specific antibiotics (n = 125, 38%) or lowered for all antibiotics (n = 79, 24%). SAT was prescribed for a lifelong duration (n = 43, 13%), a fixed duration (range 6 months–3 years) (n = 104, 32%) or for an undetermined duration (n = 154, 47%). Conclusions: Approach to SAT in PJI is highly regional, with no consensus regarding the indication, selection, dose, or duration of SAT between physicians worldwide. This reflects the paucity of data and need for high quality studies to define the optimal use of SAT in the treatment of patients with PJI.
- Subject
- prosthetic joint infection; antimicrobial treatment; suppressive; survey
- Identifier
- http://hdl.handle.net/1959.13/1516507
- Identifier
- uon:56986
- Identifier
- ISSN:0163-4453
- Rights
- /© 2024 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Language
- eng
- Full Text
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