Articles | Volume 10, issue 4
https://doi.org/10.5194/jbji-10-285-2025
https://doi.org/10.5194/jbji-10-285-2025
Original full-length article
 | 
12 Aug 2025
Original full-length article |  | 12 Aug 2025

Inadequate empirical antibiotics following debridement for orthopedic infections do not increase therapy failures

Steven Mark Maurer, Marc Simon Maurer, Marc Schmid, Stefani Dossi, Lucienne Gautier, Aileen Elizabeth Boyd, Mazda Farshad, and Ilker Uçkay

Related authors

Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge
Steven M. Maurer, Zehra S. Hepp, Shawna McCallin, Felix W. A. Waibel, Federico C. Romero, Yılmaz Zorman, Benjamin A. Lipsky, and İlker Uçkay
J. Bone Joint Infect., 7, 61–70, https://doi.org/10.5194/jbji-7-61-2022,https://doi.org/10.5194/jbji-7-61-2022, 2022
Short summary

Related subject area

Subject: Treatment outcome analysis | Topic: All topics
One- versus two-stage septic hip and knee revision surgery: a comparative cohort outcome study with short- to mid-term follow-up
Michelle M. J. Jacobs, Petra J. C. Heesterbeek, Karin Veerman, and Jon H. M. Goosen
J. Bone Joint Infect., 10, 185–192, https://doi.org/10.5194/jbji-10-185-2025,https://doi.org/10.5194/jbji-10-185-2025, 2025
Short summary
Postoperative antibiotic treatment does not lower re-revision rate in presumed aseptic hip and knee revision arthroplasties with unexpected positive intraoperative cultures – a matched cohort study
Sebastian Simon, Marjan Wouthuyzen-Bakker, Susana Gardete Hartmann, Jennyfer A. Mitterer, Sujeesh Sebastian, Stephanie Huber, Bernhard J. H. Frank, and Jochen G. Hofstaetter
J. Bone Joint Infect., 10, 51–59, https://doi.org/10.5194/jbji-10-51-2025,https://doi.org/10.5194/jbji-10-51-2025, 2025
Short summary
Optimal antibiotics duration following surgical management of septic olecranon bursitis: a 12-year retrospective analysis
Said El Zein, Elie F. Berbari, Allison M. LeMahieu, Anil Jagtiani, Parham Sendi, Abinash Virk, Mark E. Morrey, and Aaron J. Tande
J. Bone Joint Infect., 9, 107–115, https://doi.org/10.5194/jbji-9-107-2024,https://doi.org/10.5194/jbji-9-107-2024, 2024
Short summary
A desirability of outcome ranking (DOOR) for periprosthetic joint infection – a Delphi analysis
Brenton P. Johns, David C. Dewar, Mark R. Loewenthal, Laurens A. Manning, Amit Atrey, Nipun Atri, David G. Campbell, Michael Dunbar, Christopher Kandel, Amir Khoshbin, Christopher W. Jones, Jaime Lora-Tamayo, Catherine McDougall, Dirk Jan F. Moojen, Jonathan Mulford, David L. Paterson, Trisha Peel, Michael Solomon, Simon W. Young, and Joshua S. Davis
J. Bone Joint Infect., 7, 221–229, https://doi.org/10.5194/jbji-7-221-2022,https://doi.org/10.5194/jbji-7-221-2022, 2022
Short summary
Higher 1-year risk of implant removal for culture-positive than for culture-negative DAIR patients following 359 primary hip or knee arthroplasties
Joyce van Eck, Wai-Yan Liu, Jon H. M. Goosen, Wim H. C. Rijnen, Babette C. van der Zwaard, Petra Heesterbeek, Walter van der Weegen, and the further members of Regional Prosthetic Joint Infection Group
J. Bone Joint Infect., 7, 143–149, https://doi.org/10.5194/jbji-7-143-2022,https://doi.org/10.5194/jbji-7-143-2022, 2022
Short summary

Cited articles

Berbari, E. F., Marculescu, C., Sia, I., Lahr, B. D., Hanssen, A. D., Steckelberg, J. M., Gullerud, R., and Osmon, D. R.: Culture-negative prosthetic joint infection, Clin. Infect. Dis., 45, 1113–1139, https://doi.org/10.1086/522184, 2007. 
Campbell, K. A., Stein, S., Looze, C., and Bosco, J. A.: Antibiotic stewardship in orthopaedic surgery: principles and practice, J. Am. Acad. Orthop. Surg., 22, 772–781, https://doi.org/10.5435/JAAOS-22-12-772, 2014. 
Charles, P. G., Uçkay, I., Kressmann, B., Emonet, S., and Lipsky, B. A.: The role of anaerobes in diabetic foot infections, Anaerobe, 34, 8–13, https://doi.org/10.1016/j.anaerobe.2015.03.009, 2015. 
Davey, P. G. and Marwick, C.: Appropriate vs. inappropriate antimicrobial therapy, Clin. Microbiol. Infect., 14, 15–21, https://doi.org/10.1111/j.1469-0691.2008.01959.x, 2008. 
Dudareva, M., Kümin, M., Vach, W., Kaier, K., Ferguson, J., McNally, M., and Scarborough, M.: Short or Long Antibiotic Regimes in Orthopaedics (SOLARIO): a randomised controlled open-label non-inferiority trial of duration of systemic antibiotics in adults with orthopaedic infection treated operatively with local antibiotic therapy, Trials, 20, 693, https://doi.org/10.1186/s13063-019-3832-3, 2019. 
Download
Short summary

Empirical antibiotics should target likely pathogens if stewardship is followed, yet broader coverage is often used in orthopedic infections due to fear of failure. This retrospective case-control study examined surgically managed orthopedic infections, comparing accurate and inaccurate empirical antibiotic choices. Delays in switching to targeted antibiotics did not impact outcomes. Broad-spectrum regimens offered no advantage, supporting narrower choices for mild to moderate infections.

Share