304. Comparison of Short and Long Courses of Antibiotics in Patients with Prosthetic Joint Infection: A Systemic Review and Meta-analysis
Session: Poster Abstract Session: Bone and Joint Infections
Thursday, October 4, 2018
Room: S Poster Hall
  • PJI IDSA poster_Ronan Hsieh.pdf (611.1 kB)
  • Background: Current guidelines for treatment of prosthetic joint infection (PJI) suggest a combination of intravenous (IV) antibiotics for 2 to 6 weeks and oral antibiotics for 3 to 6 months. However, recent studies did not find significant benefits of prolonged use of antibiotics for patients with PJI. We conducted a systemic review and meta-analysis to assess the outcomes of short- and long-term antibiotics in patients with PJI.

    Methods: We designed three queries to retrieve literature of PJI from PubMed and Embase databases until December 2017. Each query comprised medical subject headings, title/abstract keywords, and exclusion terms. Two reviewers independently screened literatures for three rounds and disagreements were resolved by a third reviewer. Quality of a cohort study and that of a randomized control trial (RCT) were assessed by Newcastle-Ottawa Quality Assessment Form and a modified Jadad scale respectively.

    Results: 3,309 studies were retrieved, and 9 observation studies and 1 RCT were included for final analysis (Figure 1). 9 of the 10 studies investigated total hip arthroplasty and/or total knee arthropathy, while 1 study further included shoulder, elbow and ankle arthroplasty. 5 studies focused on patients receiving debridement and implant retention (DAIR) procedure, 3 studies on staged exchange arthroplasty (SEA), and 2 studies on mixed procedures. 8 of the 10 studies were graded as good or fair quality. All of the 10 studies found equivalent outcomes in patients prescribed with short- and long-term antibiotics, regardless of IV or oral form of antibiotics. The aggregate odds ratio (OR) in our meta-analysis was 1.04 (95% CI, 0.70, 1.55), showing no significant difference in outcomes between short-term and long-term antibiotics (Figure 2).

    Conclusion: Our meta-analysis demonstrated that patients prescribed with short-term antibiotics for PJI had similar outcomes as compared to those prescribed with long-term antibiotics.


    Ronan Hsieh, M.D.1, Hung-Teng Yen, M.S.2, Chung-Yen Huang, M.S.2 and Chien-Chang Lee, M.D., Sc.D.3, (1)Internal Medicine, Albert Einstein Medical Center, Philadelphia, PA, (2)Medicine, National Taiwan University, Taipei, Taiwan, (3)Emergency Medicine, National Taiwan University, Taipei, Taiwan


    R. Hsieh, None

    H. T. Yen, None

    C. Y. Huang, None

    C. C. Lee, None

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