Marion Le Maréchal1,2, Zoé Cavalli3, Cécile Batailler4, Jean-François Gonzalez5,6, André Ferreira7, Sébastien Lustig4, Tristan Ferry4,8, Johan Courjon9,10. 1. Centre Hospitalier de Grenoble, Grenoble, France. 2. Université de Grenoble-Alpes, Grenoble, France. 3. Hôpital de Mercy, Centre Hospitalier Régional de Metz-Thionville, Ars-Laquenexy, France. 4. Claude Bernard University Lyon 1, Villeurbanne, France. 5. Université Côte d'Azur, Nice, France. 6. Université Côte d'Azur, CHU, INSERM, C3M, Nice, France. 7. Société Française de chirurgie de la hanche et du genou, Paris, France. 8. CRIOAc Lyon, Lyon, France. 9. Université Côte d'Azur, CHU, INSERM, C3M, Nice, France. courjon.j@chu-nice.fr. 10. Infectiologie, Hôpital Archet 1, Centre Hospitalier Universitaire de Nice, Nice, France. courjon.j@chu-nice.fr.
Abstract
BACKGROUND: Prosthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based on clinical cases, to evaluate how French physicians manage PJI. Eligible participants were all physicians involved in care of patients presenting a PJI. Physicians could answer individually, or collectively during a multidisciplinary team meeting dedicated to PJI. The survey consisted as three questionnaires organized in a total of six clinical cases. RESULTS: Answers from the CRIOACs to the three questionnaires were 92, 77, and 53%. Between 32 and 39% of respondents did not administer antibiotic prophylaxis despite positive S. aureus pre-operative documentation. One-stage exchange strategy was widely preferred in all clinical cases, with no difference between CRIOACs and other centres. Rifampicin was prescribed for S. aureus PJI, in a situation with (90-92%) or without any prosthesis (70%). There was no consensus for the total antibiotic regimen duration, with prescriptions from six to 12 weeks for a majority of respondents. CONCLUSIONS: Surgical strategy for the management of PJI was homogenous with a preference for a one-stage exchange strategy. Medical management was more heterogenous, which reflects the heterogeneity of those infections and difficulties to perform studies with strong conclusions.
BACKGROUND:Prosthetic joint infections (PJI) are one of the most serious complication of arthroplasty. The management of PJI needs a multidisciplinary collaboration between orthopaedic surgeon, infectious disease specialist and microbiologist. In France, the management of PJI is organized around reference centres (CRIOACs). Our main objective was to perform an audit through a questionnaire survey based on clinical cases, to evaluate how French physicians manage PJI. Eligible participants were all physicians involved in care of patients presenting a PJI. Physicians could answer individually, or collectively during a multidisciplinary team meeting dedicated to PJI. The survey consisted as three questionnaires organized in a total of six clinical cases. RESULTS: Answers from the CRIOACs to the three questionnaires were 92, 77, and 53%. Between 32 and 39% of respondents did not administer antibiotic prophylaxis despite positive S. aureus pre-operative documentation. One-stage exchange strategy was widely preferred in all clinical cases, with no difference between CRIOACs and other centres. Rifampicin was prescribed for S. aureus PJI, in a situation with (90-92%) or without any prosthesis (70%). There was no consensus for the total antibiotic regimen duration, with prescriptions from six to 12 weeks for a majority of respondents. CONCLUSIONS: Surgical strategy for the management of PJI was homogenous with a preference for a one-stage exchange strategy. Medical management was more heterogenous, which reflects the heterogeneity of those infections and difficulties to perform studies with strong conclusions.
Authors: Javier Ariza; Javier Cobo; Josu Baraia-Etxaburu; Natividad Benito; Guillermo Bori; Javier Cabo; Pablo Corona; Jaime Esteban; Juan Pablo Horcajada; Jaime Lora-Tamayo; Oscar Murillo; Julián Palomino; Jorge Parra; Carlos Pigrau; José Luis Del Pozo; Melchor Riera; Dolores Rodríguez; Mar Sánchez-Somolinos; Alex Soriano; M Dolores Del Toro; Basilio de la Torre Journal: Enferm Infecc Microbiol Clin Date: 2017-02-16 Impact factor: 1.731
Authors: Douglas R Osmon; Elie F Berbari; Anthony R Berendt; Daniel Lew; Werner Zimmerli; James M Steckelberg; Nalini Rao; Arlen Hanssen; Walter R Wilson Journal: Clin Infect Dis Date: 2012-12-06 Impact factor: 9.079