Kaitlyn D’Onofrio

DocwireNews

<p>In a prospective, randomized trial published in <em>Annals of the Rheumatic Diseases</em>, researchers compared two lengths of postoperative antibiotic therapy in patients who underwent surgical drainage for native joint bacterial arthritis. Challenging traditional guidelines, they found that a two-week course of treatment was not inferior to four weeks of treatment.<p>&ldquo;For almost 40 years, the recommended total duration of postsurgical systemic antibiotic therapy has been 3&ndash;6 weeks, with most clinicians prescribing 4 weeks for adults,&rdquo; the study authors wrote. &ldquo;Unfortunately, this recommendation is based on expert opinion and individual experience, rather than on research studies. Furthermore, clinicians often treat bacterial arthritis at all anatomic sites in the same way, with no distinction between small and large joints.&rdquo;</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial.<a href="https://t.co/7PaszRvwB1">https://t.co/7PaszRvwB1</a></p>
<p>&mdash; Luis Zurita G. (@LuisZuritaG) <a href="https://twitter.com/LuisZuritaG/status/1121192385776640001?ref_src=twsrc%5Etfw">April 24, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><p>The single-center study was conducted from March 1, 2015, through March 10, 2018. Inclusion criteria were native joint bacterial arthritis patients aged &ge; 18 years who underwent at least one articular lavage (by arthrotomy or arthroscopy; with or without synovectomy), and who received systemic antibiotic therapy treatment. Exclusion criteria included recurrent bacterial arthritis, non-bacterial arthritis, history of allergies to multiple antibiotics, long-term prophylaxis use due to immune-suppression, left-side endocarditis, incomplete joint lavage or &gt; 4 surgical lavages, plans to undergo repetitive arthrocentesis therapy, concomitant spondylodiscitis or osteomyelitis, plans for arthrodesis or amputation, foot arthritis in a diabetes mellitus patient, necrotiing fasciitis, intravertebral arthritis, presence of or plan for a Girdlestone procedure, prior bone marrow transplantation, active oncological chemotherapy, or presence of foreign material in close vicinity to the infected joint. Infection with mycobacteria, actinomycetes, gonococci, meningococci, fungi, brucellosis, mycoplasma, or nocardia were also excluded because current guidelines recommend either an unusually long or short course of antibiotics.</p><h2><strong>Treatment Successful in Both Patient Groups</strong></h2><p>Final analysis included 154 cases; 77 each received two weeks and four weeks of antibiotic treatment. Median intravenous antibiotic treatment length was 1 day in the four-week cohort and 2 days in the two-week group. Three patients presented recurrent infection: one in the two-week group (99% cure rate) and two in the four-week group (97% cure rate). There were no between-group differences in the number of adverse events or sequelae.</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">Two wks vs 4 wks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: <br>&#128073;&#127995;No difference in rates of clinical remission, adverse events or postinfect sequelae after only 2 wks of antibiotic treatment <a href="https://twitter.com/hashtag/septicarthritis?src=hash&amp;ref_src=twsrc%5Etfw">#septicarthritis</a> <a href="https://twitter.com/ARD_BMJ?ref_src=twsrc%5Etfw">@ARD_BMJ</a> <a href="https://t.co/cnJMjA8VZh">https://t.co/cnJMjA8VZh</a></p>
<p>&mdash; Reumatolog&iacute;a Clinic (@Reumaclinic) <a href="https://twitter.com/Reumaclinic/status/1121273937596485633?ref_src=twsrc%5Etfw">April 25, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><p>The researchers conducted a subgroup analysis of hand and wrist cases (n = 99) because they made up the majority of the total cohort. There were three recurrences in this group&mdash;one in the two-week arm (97% cure rate) and two in the four-week arm (96% cure rate). They observed sequelae in half of the two-week cohort and 55% of the four-week group; five and six patients, respectively, required further interventions.</p><p>The study authors concluded, &ldquo;As there are many clinical and economic advantages, and apparently no disadvantages, to shorter courses of antibiotic therapy, patients with hand bacterial arthritis might benefit from shorter treatment courses. Similarly, our data support an earlier switch from parenteral to oral antibiotic therapy for these patients, which could help reduce financial costs, length of hospital stay and potentially intravenous line-related complications.&rdquo;</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial <a href="https://t.co/3zmwx9yNum">https://t.co/3zmwx9yNum</a>   Another study challenging dogma.  <a href="https://twitter.com/hashtag/septicarthritis?src=hash&amp;ref_src=twsrc%5Etfw">#septicarthritis</a> <a href="https://twitter.com/hashtag/howmuchisenough?src=hash&amp;ref_src=twsrc%5Etfw">#howmuchisenough</a></p>
<p>&mdash; Marie Kuchynski MD (@Doctorkuch) <a href="https://twitter.com/Doctorkuch/status/1120660502491869187?ref_src=twsrc%5Etfw">April 23, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p></p>


Jordana Jampel

Positive Preliminary Results From Phase 1 Trial of Dopaminergic Neuron Graft for Parkinson’s Disease

Dementia

Bradley Warady, MD

Joel M. Topf, MD, FACP

2025 Hume Award Winner Is Dedicated to Children’s Care

NKF Spring Clinical Meetings 2025

Distant Brain Metastases in Cutaneous Melanoma May Be Mitigated With Multiple Pathway Inhibitors

Melanoma

Latest News

How Long Should Patients Take Antibiotics after Operative Treatment for Native Joint Bacterial Arthritis?

Rheumatology

In a prospective, randomized trial published in Annals of the Rheumatic Diseases, researchers compared two lengths of postoperative antibiotic therapy in patients who ...

How Long Should Patients Take Antibiotics after Operative Treatment for Native Joint Bacterial

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe