|Title:||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||Authors:||Yen, Hung Teng
Hsieh, Ronan W.
Huang, Chung Yen
Hsu, Tzu Chun
|Issue Date:||1-Sep-2019||Publisher:||OXFORD UNIV PRESS||Journal Volume:||74||Journal Issue:||9||Start page/Pages:||2507||Source:||Journal of Antimicrobial Chemotherapy||Abstract:||
© 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.
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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