Suppr超能文献

人工肩关节感染:利福平能改善预后吗?一项回顾性、多中心、观察性研究。

Prosthetic Shoulder Joint Infection by : Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study.

作者信息

Vilchez Helem H, Escudero-Sanchez Rosa, Fernandez-Sampedro Marta, Murillo Oscar, Auñón Álvaro, Rodríguez-Pardo Dolors, Jover-Sáenz Alfredo, Del Toro Mª Dolores, Rico Alicia, Falgueras Luis, Praena-Segovia Julia, Guío Laura, Iribarren José A, Lora-Tamayo Jaime, Benito Natividad, Morata Laura, Ramirez Antonio, Riera Melchor

机构信息

Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain.

Infectious Diseases Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.

出版信息

Antibiotics (Basel). 2021 Apr 21;10(5):475. doi: 10.3390/antibiotics10050475.

Abstract

This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of -related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with -related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with -related PJI (median age, 67.5 years (IQR, 57.3-75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included β-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80-58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08-105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with β-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI.

摘要

这项回顾性多中心观察性研究旨在描述与假体关节感染(PJI)相关的手术和药物治疗的结果以及基于利福平疗法的潜在益处。纳入了2003年1月至2016年12月期间被诊断并接受治疗的与假体相关的PJI患者。我们分析了44例与假体相关的PJI患者(中位年龄67.5岁(四分位间距,57.3 - 75.8));75%为男性。根据冢山分类,大多数(61.4%)为晚期慢性感染。所有患者均接受了手术治疗,大多数抗生素方案(43.2%)包括β-内酰胺类。34例患者(87.17%)治愈;5例复发。最终结果(治愈与复发)显示,在同一关节有既往假体(比值比:6.89;95%置信区间:0.80 - 58.90)或既往手术及感染(比值比:10.67;95%置信区间:1.08 - 105.28)的患者中,失败频率有升高的非显著趋势。单独使用克林霉素治疗的患者复发率更高(40.0%对8.8%)。利福平治疗并未降低接受β-内酰胺类治疗患者的复发率。同一关节的既往假体、手术或感染可能与复发有关,基于利福平的联合用药似乎并未改善预后。清创和保留植入物似乎是早期PJI手术治疗的安全选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5998/8143127/ca71eec91d6d/antibiotics-10-00475-g001.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验