Le Vavasseur Benjamin, Zeller Valérie
Referral Center for Complex Bone and Joint Infections, Diaconesses Croix Saint-Simon Hospital, 75020 Paris, France.
Department of Internal Medicine and Infectious Diseases, Diaconesses Croix Saint-Simon Hospital, 75020 Paris, France.
Antibiotics (Basel). 2022 Apr 5;11(4):486. doi: 10.3390/antibiotics11040486.
Prosthetic joint infection (PJI) is a severe complication after arthroplasty. Its management combines surgical intervention, whose type depends on the clinical situation, and prolonged high-dose antibiotics adapted to the responsible microorganism(s) and the patient. Antibiotics are only one part of the therapeutic regimen and are closely related to the surgical strategy. Their efficacy depends to a large extent on the choice and quality of the surgical procedure, and the quality of the microbiological diagnosis. Although guidelines have been published, many aspects of antibiotic therapy remain poorly established. Choosing the optimal agent(s) is one aspect, with others being optimization of drugs' pharmacokinetic/pharmacodynamic parameters, the choice of administration route, use of monotherapy or combination regimens, therapeutic drug-monitoring and patient education to improve compliance and tolerance. Herein, we address PJI management based on recent literature data, guidelines and the experience of our referral center for complex bone-and-joint infections.
人工关节感染（PJI）是关节置换术后的一种严重并发症。其治疗方法包括手术干预（手术类型取决于临床情况）以及根据致病微生物和患者情况使用的长期大剂量抗生素。抗生素只是治疗方案的一部分，并且与手术策略密切相关。它们的疗效在很大程度上取决于手术程序的选择和质量以及微生物诊断的质量。尽管已经发布了指南，但抗生素治疗的许多方面仍未得到充分确立。选择最佳药物是一个方面，其他方面还包括优化药物的药代动力学/药效学参数、给药途径的选择、单一疗法或联合疗法的使用、治疗药物监测以及患者教育以提高依从性和耐受性。在此，我们根据最近的文献数据、指南以及我们复杂骨与关节感染转诊中心的经验来探讨人工关节感染的管理。
