Journal of Bone and Joint Infection
Journal of Bone and Joint Infection
JBJI
Articles | Volume 11, issue 4
Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-441-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-11-441-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
Articles | Volume 11, issue 4
Review
 | 
28 Jul 2026
Review |  | 28 Jul 2026

Bromelain and N-acetylcysteine (BromAc) as novel adjunctive therapy for prosthetic joint infection: a narrative review

Brendan Parnell and David Morris

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Short summary
Prosthetic joint infections are devastating complications of joint replacements, often resisting antibiotics because bacteria hide inside a protective slime called biofilm. We reviewed laboratory evidence on BromAc, a combination of a pineapple enzyme and a mucus-thinning agent that breaks down this slime. Early experiments suggest it can disrupt biofilm and improve antibiotic access, but key questions about safety, stability, and joint-specific testing must be answered before patient use.
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