Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Drugs Aging. 2011 Jan 1;28(1):13-26. doi: 10.2165/11586530-000000000-00000.
Total joint arthroplasty (TJA) is commonly performed on older adults. Prosthetic joint infection (PJI) is a serious complication of TJA that can significantly impact quality of life and physical function. In this review, we discuss the epidemiology and risk factors for PJIs among older adults. We also offer an overview of current diagnostic, treatment and management strategies for PJI. Given the serious nature of PJI, prevention efforts remain essential. Several approaches to infection prevention exist, including antimicrobial prophylaxis and decolonization. Although there are standardized recommendations for antimicrobial prophylaxis, the specific regimens must be individualized based on the patient's drug allergies, potential for drug interactions, renal function and bodyweight. The best approach to pre-operative screening and decolonization programmes remains unclear. Each of these issues is reviewed in detail with a focus on adverse effects and current debates regarding best practice. Given the increased numbers of TJAs performed, additional research on prevention and management is critical.
全关节置换术（TJA）常用于老年人。人工关节感染（PJI）是 TJA 的一种严重并发症，可显著影响生活质量和身体功能。在这篇综述中，我们讨论了老年人 PJI 的流行病学和危险因素。我们还概述了目前 PJI 的诊断、治疗和管理策略。鉴于 PJI 的严重性，预防措施仍然至关重要。有几种预防感染的方法，包括抗菌预防和去定植。虽然有预防抗菌的标准化建议，但具体方案必须根据患者的药物过敏、药物相互作用的可能性、肾功能和体重进行个体化。术前筛查和去定植方案的最佳方法仍不清楚。这些问题都进行了详细的审查，重点是不良反应和关于最佳实践的当前争议。鉴于 TJA 的数量增加，对预防和管理的进一步研究至关重要。
