Is there a role for extended antibiotic therapy in a two-stage revision of the infected knee arthroplasty?

J Bone Joint Surg Br. 2005 Feb;87(2):171-4. doi: 10.1302/0301-620x.87b2.15640.

Abstract

All major studies have incorporated the use of prolonged courses of parenteral or oral antibiotic therapy in the management of two-stage revision of an infected total knee arthroplasty. We present a series of 59 consecutive patients, all with microbiologically-proven deep infection of a total knee arthroplasty, in whom a prolonged course of antibiotic therapy was not routinely used. The mean follow-up was 56.4 months (24 to 114). Of the 38 patients who underwent a staged exchange, infection was successfully eradicated in 34 (89%) but recurrent or persistent infection was present in four (11%). Our rate of cure for infection is similar to that reported elsewhere. We conclude that a prolonged course of antibiotic therapy seems not to alter the incidence of recurrent or persistent infection. The costs of the administration of antibiotics are high and such a regime may be unnecessary.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Knee / methods*
  • Cefuroxime / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / microbiology
  • Male
  • Middle Aged
  • Postoperative Care / methods
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / prevention & control*
  • Recurrence
  • Reoperation
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Cefuroxime