M Pradier1,2, O Robineau1,3,2, A Boucher1,3,2, M Titecat3,4,2, N Blondiaux1,2, M Valette1,2, C Loïez4,2, E Beltrand1,2, S Nguyen5, H Dézeque4,2, H Migaud3,4,2, Eric Senneville6,7,8,9. 1. Gustave Dron Hospital, 59200, Tourcoing, France. 2. French National Reference Center for Complex Osteo-articular Infections (CRIOAC Lille-Tourcoing; G4 Bone and Joint Infection Study Group), Tourcoing, France. 3. Faculty of Medicine of Lille University II, 59045, Lille Cedex, France. 4. University Hospital of Lille, 59037, Lille Cedex, France. 5. General Hospital of Béthune, 62660, Beuvry, France. 6. Gustave Dron Hospital, 59200, Tourcoing, France. esenneville@ch-tourcoing.fr. 7. Faculty of Medicine of Lille University II, 59045, Lille Cedex, France. esenneville@ch-tourcoing.fr. 8. University Hospital of Lille, 59037, Lille Cedex, France. esenneville@ch-tourcoing.fr. 9. French National Reference Center for Complex Osteo-articular Infections (CRIOAC Lille-Tourcoing; G4 Bone and Joint Infection Study Group), Tourcoing, France. esenneville@ch-tourcoing.fr.
Abstract
PURPOSE: This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs). METHODS: Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed. RESULTS: Seventy-eight patients of mean age 64 ± 17 years received cycline-base SAT in the period from January 2006 to January 2014. PJIs involved the knee in 37 patients (47%), the hip in 35 (45%), the elbow in 4 (5%), and the shoulder in 2 (3%) and were qualified as early in 31 patients (39.7%). Staphylococcus spp. were the most common pathogens accounting for 72.1% of the total number of bacterial strains identified. All included patients had surgery which consisted in debridement and implant retention in 59 of them (75.6%). Doxycycline and minocycline were prescribed as SAT in 72 (92%) and 6 (8%) patients, respectively. Adverse events were reported in 14 patients (18%), leading to SAT discontinuation in 6 of them (8%). After a mean follow-up of 1020 ± 597 days, a total of 22 (28.2%) patients had failed including 3 cases (3.8%) with documented acquisition of tetracycline resistance in initial pathogen(s). CONCLUSIONS: Our results suggest that oral cyclines used as SAT in patients treated for PJI have an acceptable tolerability and effectiveness and appear to be a reasonable option in this setting.
PURPOSE: This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs). METHODS: Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed. RESULTS: Seventy-eight patients of mean age 64 ± 17 years received cycline-base SAT in the period from January 2006 to January 2014. PJIs involved the knee in 37 patients (47%), the hip in 35 (45%), the elbow in 4 (5%), and the shoulder in 2 (3%) and were qualified as early in 31 patients (39.7%). Staphylococcus spp. were the most common pathogens accounting for 72.1% of the total number of bacterial strains identified. All included patients had surgery which consisted in debridement and implant retention in 59 of them (75.6%). Doxycycline and minocycline were prescribed as SAT in 72 (92%) and 6 (8%) patients, respectively. Adverse events were reported in 14 patients (18%), leading to SAT discontinuation in 6 of them (8%). After a mean follow-up of 1020 ± 597 days, a total of 22 (28.2%) patients had failed including 3 cases (3.8%) with documented acquisition of tetracycline resistance in initial pathogen(s). CONCLUSIONS: Our results suggest that oral cyclines used as SAT in patients treated for PJI have an acceptable tolerability and effectiveness and appear to be a reasonable option in this setting.
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