Yang, Bone Joint J 2020 - Mark Coventry Award: Microorganism-Directed Oral Antibiotics Reduce the Rate of Failure Due to Further Infection after Two-Stage Revision Hip or Knee Arthroplasty for Chronic Infection: A Multicentre Randomized Controlled Trial at a Minimum of Two Years - Article Summary

Mark Coventry Award: Microorganism-Directed Oral Antibiotics Reduce the Rate of Failure Due to Further Infection after Two-Stage Revision Hip or Knee Arthroplasty for Chronic Infection: A Multicentre Randomized Controlled Trial at a Minimum of Two Years

Yang, Knee Society Research Group, et al.·Bone Joint J·2020·108 citations·RCT

Purpose

The aim of this study was to determine if a three-month course of microorganism-directed oral antibiotics reduces the rate of failure due to further infection following two-stage revision for chronic prosthetic joint infection (PJI) of the hip and knee.

Methods

A total of 185 patients undergoing a two-stage revision in seven different centres were prospectively enrolled.
Of these patients, 93 were randomized to receive microorganism-directed oral antibiotics for three months following reimplantation; 88 were randomized to receive no antibiotics, and four were withdrawn before randomization.
Of the 181 randomized patients, 28 were lost to follow-up, six died before two years follow-up, and five with culture negative infections were excluded.
The remaining 142 patients were followed for a mean of 3.3 years (2.0 to 7.6) with failure due to a further infection as the primary endpoint.
Patients who were treated with antibiotics were also assessed for their adherence to the medication regime and for side effects to antibiotics.

Results

Nine of 72 patients (12.5%) who received antibiotics failed due to further infection compared with 20 of 70 patients (28.6%) who did not receive antibiotics (p = 0.012).
Five patients (6.9%) in the treatment group experienced adverse effects related to the administered antibiotics severe enough to warrant discontinuation.

Conclusions

This multicentre randomized controlled trial showed that a three-month course of microorganism-directed, oral antibiotics significantly reduced the rate of failure due to further infection following a two-stage revision of total hip or knee arthroplasty for chronic PJI.

Core

Mark Coventry Award: Microorganism-Directed Oral Antibiotics Reduce the Rate of Failure Due to Further Infection after Two-Stage Revision Hip or Knee Arthroplasty for Chronic Infection: A Multicentre Randomized Controlled Trial at a Minimum of Two Years.

Yang, Knee Society Research Group, et al.Bone Joint J2020108 citationsRCT