Articles | Volume 9, issue 3
https://doi.org/10.5194/jbji-9-143-2024
https://doi.org/10.5194/jbji-9-143-2024
Brief report
 | 
14 May 2024
Brief report |  | 14 May 2024

No differences in outcomes with stopping or continuing antibiotic suppression in periprosthetic joint infections

Daisuke Furukawa, Megan Dunning, Sa Shen, Amy Chang, Jenny Aronson, Derek F. Amanatullah, Gina A. Suh, and Shanthi Kappagoda

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Cited articles

Beam, E. and Osmon, D.: Prosthetic Joint Infection Update, Infect. Dis. Clin. North Am., 32, 843–859, https://doi.org/10.1016/j.idc.2018.06.005, 2018. 
Bryan, A. J., Abdel, M. P., Sanders, T. L., Fitzgerald, S. F., Hanssen, A. D., and Berry, D. J.: Irrigation and Debridement with Component Retention for Acute Infection After Hip Arthroplasty: Improved Results with Contemporary Management, J. Bone Joint Surg. Am., 6, 2011–2018, https://doi.org/10.2106/JBJS.16.01103, 2017. 
Byren, I., Bejon, P., Atkins, B. L., Angus, B., Masters, S., McLardy-Smith, P., Gundle, R., and Berendt, A.: One hundred and twelve infected arthroplasties treated with “DAIR” (debridement, antibiotics and implant retention): antibiotic duration and outcome, J. Antimicrob. Chemother., 63, 1264–1271, https://doi.org/10.1093/jac/dkp107, 2009. 
Cortes-Penfield, N., Krsak, M., Damioli, L., Henry, M., Seidelman, J., Hewlett, A., and Certain, L.: How We Approach Suppressive Antibiotic Therapy Following Debridement, Antibiotics, and Implant Retention for Prosthetic Joint Infection, Clin. Infect. Dis., 25, 188–198, https://doi.org/10.1093/cid/ciad484, 2024. 
Osmon, D. R., Berbari, E. F., Berendt, A. R., Lew, D., Zimmerli, W., Steckelberg, J. M., Rao, N., Hanssen, A., and Wilson, W. R.: Infectious Diseases Society of America, Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America, Clin. Infect. Dis., 56, e1–e25, https://doi.org/10.1093/cid/cis803, 2013. 
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Short summary
The role of long-term antibiotics after debridement, antibiotics, and implant retention (DAIR) for periprosthetic joint infections is unclear. Patients with eventual cessation of antibiotics had similar outcomes to those who remained on chronic antibiotic suppression (failure rate of 11 % for both groups). This study importantly highlights a potential opportunity to prevent unnecessary antibiotic use and spare patients from the risk of side effects and development of resistant organisms.