Antimicrobial Therapeutics for Bone and Periprosthetic Joint Infection

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 4766

Special Issue Editors

Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Tourcoing, 59200 Tourcoing, Nord-Pas-de-Calais, France
Interests: antibiotic therapy; bone and joint infections; diabetic foot infections; prosthetic joint infections
Special Issues, Collections and Topics in MDPI journals
Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Tourcoing, 59200 Tourcoing, Nord-Pas-de-Calais, France
Interests: antibiotic therapy; bone and joint infections; diabetic foot infections; prosthetic joint infections; vascular graft infections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Osteomyelitis and periprosthetic joint infections (PJIs) have gained interest in the last decades not only because of their growing prevalence but also because it is a perfect example of the importance of the collaboration of different specialists to treat these difficult-to-treat infections. While the surgical part of the management of such infections is based on general rules generally well admitted, it is not the case for the antimicrobial part. Indeed, the numerous antimicrobial agents including new antibiotics and the emergence of new conceptual ways of treating these biofilm-associated infections result in a huge number of potential antimicrobial regimens. Except for the rifampin-fluoroquinolone combinations in the case of staphylococcal PJIs, and fluoroquinolones in the case of Gram-negative bacilli PJIs, the other combinations have not been assessed by well-designed studies. Recent studies have highlighted the potential role of persistent bacteria in the recurrence of osteomyelitis which might result in another possible way to fight against this issue. Suppressive antimicrobial therapy is used by some teams but it still needs clarification in its definition and modalities of administration. The question of both duration and oral administration of antimicrobial therapy for osteomyelitis (including diabetic foot osteomyelitis) and PJIs has been addressed in recent well-designed studies. This Special Issue seeks manuscript submissions that further our understanding of antimicrobial therapy for osteomyelitis and PJIs. Submissions on new antimicrobial approaches especially bacteriophages, prevention of recurrence, and innovative antimicrobial regimens are especially encouraged.

Prof. Dr. Éric M. Senneville
Dr. Olivier Robineau
Guest Editors

Manuscript Submission Information

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Keywords

  • osteomyelitis
  • diabetic foot osteomyelitis
  • periprosthetic joint infections
  • antimicrobial therapy
  • recurrence
  • persistence
  • biofilm

Published Papers (3 papers)

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Research

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10 pages, 676 KiB  
Article
Outcome of Irrigation and Debridement with Topical Antibiotic Delivery Using Antibiotic-Impregnated Calcium Hydroxyapatite for the Management of Periprosthetic Hip Joint Infection
by Hiroki Wakabayashi, Masahiro Hasegawa, Yohei Naito, Shine Tone and Akihiro Sudo
Antibiotics 2023, 12(5), 938; https://doi.org/10.3390/antibiotics12050938 - 21 May 2023
Cited by 1 | Viewed by 1174
Abstract
We assessed the clinical results of irrigation and debridement (I&D) with antibiotic-impregnated calcium hydroxyapatite (CHA) as a novel antibiotic delivery system for the treatment of prosthetic-joint-associated infection (PJI) after total hip arthroplasty (THA). Thirteen patients (14 hips) treated with I&D for PJI after [...] Read more.
We assessed the clinical results of irrigation and debridement (I&D) with antibiotic-impregnated calcium hydroxyapatite (CHA) as a novel antibiotic delivery system for the treatment of prosthetic-joint-associated infection (PJI) after total hip arthroplasty (THA). Thirteen patients (14 hips) treated with I&D for PJI after THA at our institution between 1997 and 2017 were retrospectively evaluated. The study group included four men (five hips) and nine women, with an average age of 66.3 years. Four patients (five hips) had symptoms of infection within less than 3 weeks; however, nine patients had symptoms of infection over 3 weeks. All patients received I&D with antibiotic-impregnated CHA in the surrounding bone. In two hips (two cups and one stem), cup and/or stem revision were performed with re-implantation because of implant loosening. In ten patients (11 hips), vancomycin hydrochloride was impregnated in the CHA. The average duration of follow-up was 8.1 years. Four patients included in this study died of other causes, with an average follow-up of 6.7 years. Eleven of thirteen patients (12 of 14 hips) were successfully treated, and no signs of infection were observed at the latest follow-up. In two patients (two hips) for whom treatment failed, infection was successfully treated with two-stage re-implantation. Both patients had diabetes mellitus and symptoms of infection over 3 weeks. Eighty-six percent of patients were successfully treated. No complications were observed with this antibiotic-impregnated CHA. I&D treatment with antibiotic-impregnated CHA produced a higher rate of success in patients with PJI after THA. Full article
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Review

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17 pages, 537 KiB  
Review
Appropriate Duration of Antimicrobial Treatment for Prosthetic Joint Infections: A Narrative Review
by Jaime Lora-Tamayo, Mikel Mancheño-Losa, María Ángeles Meléndez-Carmona, Pilar Hernández-Jiménez, Natividad Benito and Oscar Murillo
Antibiotics 2024, 13(4), 293; https://doi.org/10.3390/antibiotics13040293 - 23 Mar 2024
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Abstract
Prosthetic joint infections are considered difficult to treat they needing aggressive surgery and long antimicrobial treatments. However, the exact duration of these therapies has been established empirically. In the last years, several studies have explored the possibility of reducing the length of treatment [...] Read more.
Prosthetic joint infections are considered difficult to treat they needing aggressive surgery and long antimicrobial treatments. However, the exact duration of these therapies has been established empirically. In the last years, several studies have explored the possibility of reducing the length of treatment in this setting, with conflicting results. In this narrative review, we critically appraise the published evidence, considering the different surgical approaches (implant retention [DAIR] and one-step and two-step exchange procedures) separately. In patients managed with DAIR, usually treated for at least 12 weeks, a large, randomized trial failed to show that 6 weeks were non-inferior. However, another randomized clinical trial supports the use of 8 weeks, as long as the surgical conditions are favorable and antibiotics with good antibiofilm activity can be administered. In patients managed with a two-step exchange procedure, usually treated during 6 weeks, a randomized clinical trial showed the efficacy of a 4-week course of antimicrobials. Also, the use of local antibiotics may allow the use of even shorter treatments. Finally, in the case of one-step exchange procedures, there is a trend towards reducing the length of therapy, and the largest randomized clinical trial supports the use of 6 weeks of therapy. Full article
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Other

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9 pages, 2247 KiB  
Case Report
Ceftazidime-Avibactam as Osteomyelitis Therapy: A Miniseries and Review of the Literature
by Alessandro Mancuso, Luca Pipitò, Raffaella Rubino, Salvatore Antonino Distefano, Donatella Mangione and Antonio Cascio
Antibiotics 2023, 12(8), 1328; https://doi.org/10.3390/antibiotics12081328 - 17 Aug 2023
Cited by 1 | Viewed by 2223
Abstract
Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic options. Although not approved for these indications, an ever-growing amount of evidence supports the efficacy and safety of ceftazidime–avibactam as a therapy for osteomyelitis and [...] Read more.
Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic options. Although not approved for these indications, an ever-growing amount of evidence supports the efficacy and safety of ceftazidime–avibactam as a therapy for osteomyelitis and prosthetic joint infections. Here, we present three cases of difficult-to-treat resistant Pseudomonas aeruginosa osteomyelitis that were successfully treated with ceftazidime–avibactam alone or in combination therapy with fosfomycin and amikacin. Ceftazidime–avibactam was prescribed at a daily dose of 2.5 g every 8 h for 42 days in all cases. One potential drug-related adverse effect was observed, i.e., Clostridioides difficile infection, which occurred after fourteen days of treatment with ceftazidime–avibactam. Full article
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