Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention
Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Puhto, Ari-Pekka [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
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| Anmerkung: |
© SICOT aisbl 2015 |
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| Übergeordnetes Werk: |
Enthalten in: International orthopaedics - Berlin : Springer, 1977, 39(2015), 9 vom: 03. Juli, Seite 1785-1791 |
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| Übergeordnetes Werk: |
volume:39 ; year:2015 ; number:9 ; day:03 ; month:07 ; pages:1785-1791 |
| Links: |
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| DOI / URN: |
10.1007/s00264-015-2819-2 |
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| Katalog-ID: |
SPR003277151 |
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| 520 | |a Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. | ||
| 650 | 4 | |a Prosthetic joint infection |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Total knee arthroplasty |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Total hip arthroplasty |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Risk factors |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Outcome |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Rifampin |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Puhto, Teija |4 aut | |
| 700 | 1 | |a Niinimäki, Tuukka |4 aut | |
| 700 | 1 | |a Ohtonen, Pasi |4 aut | |
| 700 | 1 | |a Leppilahti, Juhana |4 aut | |
| 700 | 1 | |a Syrjälä, Hannu |4 aut | |
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10.1007/s00264-015-2819-2 doi (DE-627)SPR003277151 (SPR)s00264-015-2819-2-e DE-627 ger DE-627 rakwb eng Puhto, Ari-Pekka verfasserin aut Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © SICOT aisbl 2015 Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 Puhto, Teija aut Niinimäki, Tuukka aut Ohtonen, Pasi aut Leppilahti, Juhana aut Syrjälä, Hannu aut Enthalten in International orthopaedics Berlin : Springer, 1977 39(2015), 9 vom: 03. Juli, Seite 1785-1791 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 https://dx.doi.org/10.1007/s00264-015-2819-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2015 9 03 07 1785-1791 |
| spelling |
10.1007/s00264-015-2819-2 doi (DE-627)SPR003277151 (SPR)s00264-015-2819-2-e DE-627 ger DE-627 rakwb eng Puhto, Ari-Pekka verfasserin aut Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © SICOT aisbl 2015 Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 Puhto, Teija aut Niinimäki, Tuukka aut Ohtonen, Pasi aut Leppilahti, Juhana aut Syrjälä, Hannu aut Enthalten in International orthopaedics Berlin : Springer, 1977 39(2015), 9 vom: 03. Juli, Seite 1785-1791 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 https://dx.doi.org/10.1007/s00264-015-2819-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2015 9 03 07 1785-1791 |
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10.1007/s00264-015-2819-2 doi (DE-627)SPR003277151 (SPR)s00264-015-2819-2-e DE-627 ger DE-627 rakwb eng Puhto, Ari-Pekka verfasserin aut Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © SICOT aisbl 2015 Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 Puhto, Teija aut Niinimäki, Tuukka aut Ohtonen, Pasi aut Leppilahti, Juhana aut Syrjälä, Hannu aut Enthalten in International orthopaedics Berlin : Springer, 1977 39(2015), 9 vom: 03. Juli, Seite 1785-1791 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 https://dx.doi.org/10.1007/s00264-015-2819-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2015 9 03 07 1785-1791 |
| allfieldsGer |
10.1007/s00264-015-2819-2 doi (DE-627)SPR003277151 (SPR)s00264-015-2819-2-e DE-627 ger DE-627 rakwb eng Puhto, Ari-Pekka verfasserin aut Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © SICOT aisbl 2015 Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 Puhto, Teija aut Niinimäki, Tuukka aut Ohtonen, Pasi aut Leppilahti, Juhana aut Syrjälä, Hannu aut Enthalten in International orthopaedics Berlin : Springer, 1977 39(2015), 9 vom: 03. Juli, Seite 1785-1791 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 https://dx.doi.org/10.1007/s00264-015-2819-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2015 9 03 07 1785-1791 |
| allfieldsSound |
10.1007/s00264-015-2819-2 doi (DE-627)SPR003277151 (SPR)s00264-015-2819-2-e DE-627 ger DE-627 rakwb eng Puhto, Ari-Pekka verfasserin aut Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © SICOT aisbl 2015 Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 Puhto, Teija aut Niinimäki, Tuukka aut Ohtonen, Pasi aut Leppilahti, Juhana aut Syrjälä, Hannu aut Enthalten in International orthopaedics Berlin : Springer, 1977 39(2015), 9 vom: 03. Juli, Seite 1785-1791 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 https://dx.doi.org/10.1007/s00264-015-2819-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2015 9 03 07 1785-1791 |
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Enthalten in International orthopaedics 39(2015), 9 vom: 03. Juli, Seite 1785-1791 volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 |
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Enthalten in International orthopaedics 39(2015), 9 vom: 03. Juli, Seite 1785-1791 volume:39 year:2015 number:9 day:03 month:07 pages:1785-1791 |
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Prosthetic joint infection Total knee arthroplasty Total hip arthroplasty Risk factors Outcome Rifampin |
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International orthopaedics |
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Puhto, Ari-Pekka @@aut@@ Puhto, Teija @@aut@@ Niinimäki, Tuukka @@aut@@ Ohtonen, Pasi @@aut@@ Leppilahti, Juhana @@aut@@ Syrjälä, Hannu @@aut@@ |
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Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. 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Puhto, Ari-Pekka |
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Puhto, Ari-Pekka misc Prosthetic joint infection misc Total knee arthroplasty misc Total hip arthroplasty misc Risk factors misc Outcome misc Rifampin Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention |
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Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention Prosthetic joint infection (dpeaa)DE-He213 Total knee arthroplasty (dpeaa)DE-He213 Total hip arthroplasty (dpeaa)DE-He213 Risk factors (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Rifampin (dpeaa)DE-He213 |
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Puhto, Ari-Pekka Puhto, Teija Niinimäki, Tuukka Ohtonen, Pasi Leppilahti, Juhana Syrjälä, Hannu |
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predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention |
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Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention |
| abstract |
Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. © SICOT aisbl 2015 |
| abstractGer |
Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. © SICOT aisbl 2015 |
| abstract_unstemmed |
Purpose The reported success rates of debridement, antibiotics, and implant retention (DAIR) for prosthetic joint infections (PJIs) vary widely. Several risk factors have been described for treatment failure, but they vary between studies. The purpose of this study was to evaluate the predictors of DAIR failure in PJI treatment and to assess the efficacy of rifampin combined with ciprofloxacin versus rifampin combined with other antibiotics in staphylococcal PJIs. Methods Patients with PJI that underwent DAIR for the first time between February 2001 and August 2009 were identified retrospectively in the hospital’s patient databases. A total of 113 PJI cases with early postoperative or acute haematogenous PJI were followed for up to two years from the start of treatment. Results In univariate analysis, variables significantly associated with treatment failure were acute haematogenous infections (p = 0.022), leucocyte count at admission > 10 × $ 10^{9} $/l (p < 0.01), pain in the joint (p < 0.01), and ineffective empirical antibiotics (p < 0.01). In a multivariate Cox model, leucocyte count > 10 × $ 10^{9} $/l and ineffective empirical antibiotics were significant risk factors for failure. Compared to rifampin-ciprofloxacin, the hazard ratio (HR) for treatment failure was significantly increased in the rifampin-other antibiotics group (HR 6.0, 95 % CI 1.5−28.8, p = 0.014) and the group treated without rifampin (HR 14.4, 95 % CI 3.1−66.9, p < 0.01). Conclusions Rifampin-ciprofloxacin combination therapy was significantly more effective than rifampin combined with other antibiotics. Effective empirical antibiotics are essential for successful PJI treatment. © SICOT aisbl 2015 |
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| title_short |
Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention |
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https://dx.doi.org/10.1007/s00264-015-2819-2 |
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Puhto, Teija Niinimäki, Tuukka Ohtonen, Pasi Leppilahti, Juhana Syrjälä, Hannu |
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Puhto, Teija Niinimäki, Tuukka Ohtonen, Pasi Leppilahti, Juhana Syrjälä, Hannu |
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10.1007/s00264-015-2819-2 |
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| score |
7.39985 |