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
Posters
  • 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

    Disclosures:

    R. Hsieh, None

    H. T. Yen, None

    C. Y. Huang, None

    C. C. Lee, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.