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high initial peak elution the antibiotic is gradually released by the cement, acts at the desired site and can reach far higher concentrations than systemic therapy without causing notable systemic side effects (see Table 1 ). By implementing this
Bucharest Emergency Clinical Hospital, Romania
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because, in conjunction with the type of causative bacteria, it can predict the formation of biofilm and thus the indication for implant removal. 11 , 12 Once the biofilm has occurred, systemic antibiotic therapy becomes ineffective, especially when
Université Claude Bernard Lyon 1, Villeurbanne, France
Centre de Références des IOA Complexes de Lyon, CRIOAc Lyon, Lyon, France
StaPath team, Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
Education and Clinical Officer of the ESCMID Study Group for Non-traditional Antibacterial Therapy (ESGNTA)
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Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium
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Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium
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application on other species within the microbiome. This contrasts with antibiotic therapy, which can often have cross-species effects. However, this specificity makes it challenging to manage a biobank of suitable phages to target the range of pathogens
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assessment, intravenous antibiotic therapy, and surgical treatment as deemed necessary. Most studies concern septic arthritis in the adult native knee joint. But, as occurs in other joints (shoulder, sternoclavicular or wrist), bacterial arthritis of the
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-fold of the minimal-inhibiting concentrations (MIC), biofilm embedded pathogens up to 1000-fold MIC for elimination 31 and these are usually not possible for systemic antibiotic therapy as well as for antibiotics released from PMMA. 32 In
Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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rates ranging from 3 to 26%, with a cumulative incidence of 9.9% ( 58 ). Proper wound cleansing and debridement are important for open fractures, as is proper antibiotic therapy. There is no universal protocol on which antibiotics to use or on the
Co-first authors and equal contributors
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Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Bone Infection Unit, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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Division of Orthopaedics and Trauma Surgery, Bone Infection Unit, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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, phage administration duration and frequency, concomitant antibiotics, suppressive antimicrobial therapy) were extracted from each record and inserted into a Microsoft® Excel table. The outcome of each treatment episode was assessed using our
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Children’s Orthopaedic Surgery (BSCOS) guidelines recommend that microbiology specimens be taken prior to antibiotic therapy administration but state that this should not delay treatment in unwell children. 29 Samples should be sent for urgent
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recurrent disease is complex and resource-intensive, often requiring multiple surgical interventions and extended periods of antibiotic therapy. A number of authors have reported unique treatment strategies. For example, Kanakaris et al describe use of a
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, 12 , 18 – 20 Empiric antibiotic therapy with or without surgical drainage and debridement are the goal standard for treatment. 7 , 9 Significant controversies exist as to the diagnostic role of acute phase reactants, synovial fluid analysis
