Articles | Volume 6, issue 8
https://doi.org/10.5194/jbji-6-337-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-6-337-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Cost of off-label antibiotic therapy for bone and joint infections: a 6-year prospective monocentric observational cohort study in a referral centre for management of complex osteo-articular infections
Truong-Thanh Pham
Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon,
France
French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
Eugénie Mabrut
French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
Philippe Cochard
Hauteville Public Hospital Centre, 01110 Hauteville-Lompnes, France
Paul Chardon
Val Rosay Rehabilitation Centre, 69370 Saint-Didier-Au-Mont-d'Or, France
Hassan Serrier
Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France
Cellule Innovation, Département de la Recherche Clinique et de
l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
Florent Valour
Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon,
France
French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
Centre International de Recherche en Infectiologie (CIRI), Inserm
U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
Laure Huot
Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France
Cellule Innovation, Département de la Recherche Clinique et de
l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
Michel Tod
Service de Pharmacie, Hospices Civils de Lyon, Lyon, France
Gilles Leboucher
Service de Pharmacie, Hospices Civils de Lyon, Lyon, France
Christian Chidiac
Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon,
France
French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
Centre International de Recherche en Infectiologie (CIRI), Inserm
U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
Tristan Ferry
CORRESPONDING AUTHOR
Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon,
France
French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
Centre International de Recherche en Infectiologie (CIRI), Inserm
U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
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Laura Bessems, Jolien Onsea, Baixing Chen, Marjan Wouthuyzen-Bakker, Irene K. Sigmund, Tristan Ferry, Richard Kuehl, Martin Clauss, Alex Soriano, Ricardo Sousa, Annette Schuermans, and Willem-Jan Metsemakers
J. Bone Joint Infect., 10, 489–500, https://doi.org/10.5194/jbji-10-489-2025, https://doi.org/10.5194/jbji-10-489-2025, 2025
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Isolation of patients with musculoskeletal infections in orthopedic care is controversial. Evidence supports selective isolation for certain resistant pathogens but not for non-resistant pathogens, nor does it support the routine use of septic wards. Effective infection control depends on hospital-wide strategies and adherence to standard precautions, with specialized centres offering better care than dedicated isolation units.
Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem-Jan Metsemakers, Martin Clauss, Alex Soriano, Rihard Trebse, and Ricardo Sousa
J. Bone Joint Infect., 10, 139–142, https://doi.org/10.5194/jbji-10-139-2025, https://doi.org/10.5194/jbji-10-139-2025, 2025
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This is a summary of our position paper on debridement, antimicrobial therapy, and implant retention (DAIR) procedures as a curative treatment strategy for acute periprosthetic hip and knee infections. It includes the defined indications as well as the contraindications of DAIR procedures when eradication/cure is intended, based on the currently available literature.
Irene K. Sigmund, Tristan Ferry, Ricardo Sousa, Alex Soriano, Willem-Jan Metsemakers, Martin Clauss, Rihard Trebse, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 10, 101–138, https://doi.org/10.5194/jbji-10-101-2025, https://doi.org/10.5194/jbji-10-101-2025, 2025
Short summary
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In this paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors of a DAIR procedure based on the currently available literature. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure.
Céline Dupieux, Ghislaine Descours, Paul Verhoeven, Florence Grattard, Yvonne Benito, François Vandenesch, Céline Cazorla, Tristan Ferry, Sébastien Lustig, Bertrand Boyer, Sandrine Boisset, Anne Carricajo, Frédéric Laurent, and PIRLA investigator group
J. Bone Joint Infect., 9, 37–48, https://doi.org/10.5194/jbji-9-37-2024, https://doi.org/10.5194/jbji-9-37-2024, 2024
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We define an algorithm to optimize bone and joint infection diagnosis in adults on synovial fluid samples. This prospective multi-center study included a large number of synovial fluids and compared the performance of classical culture on different media, inoculation of synovial fluid in blood culture bottles, and broad-range and specific PCR. We proposed an algorithm associating culture onto three solid media and into blood culture bottles and 16S, Staphylococcus, and Streptococcus PCR.
Parham Sendi and Tristan Ferry
J. Bone Joint Infect., 7, 187–189, https://doi.org/10.5194/jbji-7-187-2022, https://doi.org/10.5194/jbji-7-187-2022, 2022
Clément Javaux, Clémentine Daveau, Clotilde Bettinger, Mathieu Daurade, Céline Dupieux-Chabert, Fabien Craighero, Carine Fuchsmann, Philippe Céruse, Arnaud Gleizal, Nicolas Sigaux, Tristan Ferry, Florent Valour, and the Lyon BJI study group
J. Bone Joint Infect., 7, 127–136, https://doi.org/10.5194/jbji-7-127-2022, https://doi.org/10.5194/jbji-7-127-2022, 2022
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We describe 48 osteocutaneous-flap-related osteomyelitis cases, mostly presenting with early, local signs of infection and/or bone exposure. Main pathogens were Gram-negative bacilli, streptococci, S. aureus, enterococci, and anaerobes, justifying a broad-spectrum empirical antimicrobial therapy. Despite surgery and a 3-month antimicrobial therapy, a 50 % failure rate was recorded, associated with a delayed infectious disease specialist referral and advocating for multidisciplinary management.
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Short summary
Costs related to off-label expensive antibiotics used to treat bone and joint infections (BJIs) in a referral centre in France were analysed in this cohort study. Despite the large increase in the number of patients treated with these antibiotics, the overall costs remained stable (approximately EUR 1 million) and were helped by the appearance of generic molecules at lower prices. Production of generic antibiotics at low cost is essential to limit the financial burden of the management of BJIs.
Costs related to off-label expensive antibiotics used to treat bone and joint infections (BJIs)...