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Conservative treatment of staphylococcal prosthetic joint infections in elderly patients.
Am J Med 2006; 119(11):993.e7-10AJ

Abstract

BACKGROUND

We report the outcome of debridement and prosthesis retention plus long-term levofloxacin/rifampicin treatment of prosthetic joint infections.

METHODS

Staphylococcal prosthesis joint infections were defined by positive culture of joint aspirate, intraoperative debridement specimens, or sinus tract discharge in the presence of clinical criteria. Patients received long-term oral levofloxacin 500 mg and rifampicin 600 mg once per day. Sixty patients (age 74.6+/-8.4 years) were included.

RESULTS

Coagulase-negative staphylococci were significantly more frequently isolated in the knee (78.6%; P=.00001). Of the Staphylococcus aureus isolates, 33.3% were methicillin-resistant. Time from arthroplasty to symptoms onset was higher (P=.03) in coagulase-negative staphylococci infections. Global failure was 35% (higher for the knee) and ranged from 16.6% to 69.2% (P=.0045) in patients with symptoms duration of less than 1 month to more than 6 months. A shorter duration of symptoms (P=.001) and time to diagnosis (P=.01) were found in cured patients versus patients showing failure. Among those with S. aureus infections, a higher failure rate was found with methicillin-resistance.

CONCLUSIONS

Efficacy was higher in patients with shorter duration of symptoms, earlier diagnosis, hip infections, and methicillin susceptibility.

Authors+Show Affiliations

Infectious Diseases Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17071171

Citation

Barberán, José, et al. "Conservative Treatment of Staphylococcal Prosthetic Joint Infections in Elderly Patients." The American Journal of Medicine, vol. 119, no. 11, 2006, pp. 993.e7-10.
Barberán J, Aguilar L, Carroquino G, et al. Conservative treatment of staphylococcal prosthetic joint infections in elderly patients. Am J Med. 2006;119(11):993.e7-10.
Barberán, J., Aguilar, L., Carroquino, G., Giménez, M. J., Sánchez, B., Martínez, D., & Prieto, J. (2006). Conservative treatment of staphylococcal prosthetic joint infections in elderly patients. The American Journal of Medicine, 119(11), pp. 993.e7-10.
Barberán J, et al. Conservative Treatment of Staphylococcal Prosthetic Joint Infections in Elderly Patients. Am J Med. 2006;119(11):993.e7-10. PubMed PMID: 17071171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conservative treatment of staphylococcal prosthetic joint infections in elderly patients. AU - Barberán,José, AU - Aguilar,Lorenzo, AU - Carroquino,Guillermo, AU - Giménez,María-José, AU - Sánchez,Beatriz, AU - Martínez,David, AU - Prieto,José, PY - 2005/12/14/received PY - 2006/03/16/revised PY - 2006/03/27/accepted PY - 2006/10/31/pubmed PY - 2006/11/10/medline PY - 2006/10/31/entrez SP - 993.e7 EP - 10 JF - The American journal of medicine JO - Am. J. Med. VL - 119 IS - 11 N2 - BACKGROUND: We report the outcome of debridement and prosthesis retention plus long-term levofloxacin/rifampicin treatment of prosthetic joint infections. METHODS: Staphylococcal prosthesis joint infections were defined by positive culture of joint aspirate, intraoperative debridement specimens, or sinus tract discharge in the presence of clinical criteria. Patients received long-term oral levofloxacin 500 mg and rifampicin 600 mg once per day. Sixty patients (age 74.6+/-8.4 years) were included. RESULTS: Coagulase-negative staphylococci were significantly more frequently isolated in the knee (78.6%; P=.00001). Of the Staphylococcus aureus isolates, 33.3% were methicillin-resistant. Time from arthroplasty to symptoms onset was higher (P=.03) in coagulase-negative staphylococci infections. Global failure was 35% (higher for the knee) and ranged from 16.6% to 69.2% (P=.0045) in patients with symptoms duration of less than 1 month to more than 6 months. A shorter duration of symptoms (P=.001) and time to diagnosis (P=.01) were found in cured patients versus patients showing failure. Among those with S. aureus infections, a higher failure rate was found with methicillin-resistance. CONCLUSIONS: Efficacy was higher in patients with shorter duration of symptoms, earlier diagnosis, hip infections, and methicillin susceptibility. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/17071171/Conservative_treatment_of_staphylococcal_prosthetic_joint_infections_in_elderly_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(06)00572-9 DB - PRIME DP - Unbound Medicine ER -