Antibiotic treatment regimens for bone infection after debridement: a study of 902 cases [post]

2020 unpublished
Our aim was to investigate the clinical efficacy and complications of antibiotic treatment regimens for patients with bone infection. Methods: We retrospectively analysed patients with bone infection admitted to our hospital between March 2013 and October 2018. After surgical debridement was performed, the patients were divided into three groups: IV group (intravenous antibiotics for two weeks); oral group (intravenous antibiotics for two weeks followed by oral antibiotics for four weeks); and
more » ... r four weeks); and rifampicin group (intravenous antibiotics for two weeks followed by oral antibiotics plus rifampicin for four weeks). The infection control rate and complications were compared among the three groups. Results : A total of 902 patients were enrolled. The infection sites included 509 tibias, 228 femurs, 32 humeri, 23 radii and ulnae, 40 calcanei, and 47 miscellaneous sites, as well as 23 multiple-site infections. After at least six months of follow-up, 148 (16.4%) patients had an infection recurrence. The recurrence rate of the IV group was 17.9%, which was not significantly higher than the recurrence rates of the oral group (10.1%) and rifampicin group (10.5%), P=0.051. The incidence of abnormal alanine aminotransferase (ALT) levels in the IV group was 15.1%, which was lower than that in the oral group (18.0%) and rifampicin group (27.4%), P=0.026. The rates of proteinuria in the three groups were 3.2%, 4.5%, and 9.3%, respectively, P=0.020. Conclusions : After debridement of bone infection, short-term antibiotic treatment regimens might offer similar rates of infection eradication while avoiding the risk of renal and hepatic damage associated with prolonged antibiotic use. The Level of Clinical Relevance: Stage III. Background Bone infection is a common complication after bone fracture. Although modern medical advancements have brought the treatment of bone infections to a new height, it is still a difficult disease for orthopaedic doctors to treat. The commonly used treatments include conservative debridement, continuous flushing, antibiotic carrier filling, and others. To achieve the desired results, clinicians frequently use parenteral antibiotic therapy at a high dose for prolonged periods [1].
doi:10.21203/rs.2.18846/v4 fatcat:kdbto3fpkfcobg2kx4ysawk5dy