Abstract
BackgroundOur aim was to investigate the clinical efficacy and complications of antibiotic treatment regimens for patients with bone infection.MethodsWe 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 2 weeks); oral group (intravenous antibiotics for 2 weeks followed by oral antibiotics for 4 weeks); and rifampicin group (intravenous antibiotics for 2 weeks followed by oral antibiotics plus rifampicin for 4 weeks). The infection control rate and complications were compared among the three groups.ResultsA 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 6 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.ConclusionsAfter 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 relevanceStage III.
Highlights
Our aim was to investigate the clinical efficacy and complications of antibiotic treatment regimens for patients with bone infection
The mainstay treatment method is debridement followed by systemic antibiotic therapy, which commonly includes intravenous infusion for 2 weeks followed by oral antibiotics for 4–6 weeks [4, 5]
The patients were divided into three groups according to whether oral antibiotics were taken after surgery: an IV group; an oral group; and a rifampicin group
Summary
Our aim was to investigate the clinical efficacy and complications of antibiotic treatment regimens for patients with bone infection. The commonly used treatments include conservative debridement, continuous flushing, antibiotic carrier filling, and others. Long-term intravenous antibiotic therapy may cause complications such as catheter-related bloodstream infections and thrombosis [3]. The mainstay treatment method is debridement followed by systemic antibiotic therapy, which commonly includes intravenous infusion for 2 weeks followed by oral antibiotics for 4–6 weeks [4, 5]. There is no evidence that antibiotic therapy for 4–6 weeks leads to improved outcomes compared with shorter regimens [1]. We explored the use of a 2-week IV antibiotics regimen in the treatment of bone infection, and the overall efficacy was adequate
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