https://scholars.lib.ntu.edu.tw/handle/123456789/431113
標題: | Short-course versus long-course antibiotics in prosthetic joint infections: A systematic review and meta-analysis of one randomized controlled trial plus nine observational studies | 作者: | Yen, Hung Teng Hsieh, Ronan W. Huang, Chung Yen Hsu, Tzu Chun Yeh, Timothy YEE-CHUN CHEN WEN-SHAN CHEN CHIEN-CHANG LEE |
公開日期: | 1-九月-2019 | 出版社: | OXFORD UNIV PRESS | 卷: | 74 | 期: | 9 | 起(迄)頁: | 2507 | 來源出版物: | Journal of Antimicrobial Chemotherapy | 摘要: | © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Background: Prosthetic joint infections (PJIs) often require long-course antibiotic therapy. However, recent studies argue against the current practice and raise concerns such as the development of antibiotic resistance, side effects of medications and medical costs. Objectives: To review and compare the outcomes of short-course and long-course antibiotics in PJIs. Methods: We conducted a systemic review and meta-analysis using a predefined search term in PubMed and EMBASE databases. Studies that met the inclusion criteria from inception to June 2018 were included. The quality of the included studies was assessed. Results: A total of 10 articles and 856 patients were analysed, comprising 9 observational studies and 1 randomized controlled trial. Our meta-analysis showed no significant difference between short-course and long-course antibiotics (relative risk=0.87, 95% CI=0.62-1.22). Additionally, the older the studied group was, the more short-course antibiotics were favoured. Conclusions: When treating PJI patients following debridement, antibiotics and implant retention, an 8 week course of antibiotic therapy for total hip arthroplasty and a 75 day course for total knee arthroplasty may be a safe approach. For two-stage exchange, a shorter duration of antibiotic treatment during implant-free periods is also generally safe with the usage of antibiotic-loaded cement spacers. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/431113 | ISSN: | 03057453 | DOI: | 10.1093/jac/dkz166 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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