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Abstract
BackgroundThis study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT) (vancomycin with either cefepime, third-generation cephalosporin or piperacillin–tazobactam).MethodsWe performed a 1-year retrospective study on all the surgical procedures performed in our hospital for PJI. Susceptibility profiles of all the strains cultured from surgical samples were reviewed to compare ceftobiprole to current used associations.ResultsDuring the study period (from January 2018 to December 2018), we identified 106 patients managed for PJI and a total of 216 surgical interventions. One hundred-fifty strains were identified from intraoperative samples, excluding redundant strains. Staphylococcus spp. represented 52.7% of all strains and Enterobacteriales 13.3%. Twenty-three patients had polymicrobial infection (22%). Among 149 surgical procedures with positive culture results, ceftobiprole covered the bacterial strains in 138 (92.6%) cases. In comparison, this percentage was 94.6% for vancomycin plus cefepime (p = 0.64), 92.6% for vancomycin plus a third-generation cephalosporin in 138 cases (p = 1) and 94.6% for vancomycin plus piperacillin–tazobactam) (p = 0.64).ConclusionBased on antimicrobial susceptibility testing, our results suggest that ceftobiprole could be an interesting option for PEAT in PJIs, allowing the use of a single agent.
Highlights
This study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT)
We compared ceftobiprole to vancomycin plus cefepime, vancomycin plus third generation cephalosporin and vancomycin plus piperacillin–tazobactam in this setting
Patients During the study period, we identified 106 patients managed for PJI (57 hip prosthesis, 39 knee prosthesis, 9 shoulder prosthesis, 4 elbow prosthesis and 4 other prosthesis, with sometimes more than one prosthesis by patient)
Summary
This study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT) (vancomycin with either cefepime, third-generation cephalosporin or piperacillin–tazobactam). The results of the susceptibility profile of the bacteria isolated from the intraoperative samples usually require at least 5 days to become available During this period, an initial post-operative empirical antibiotic therapy (PEAT). Ceftobiprole is a newly commercialized beta-lactam antibiotic with a broad spectrum, equivalent to an association of a third-generation cephalosporin plus vancomycin It is active against methicillin-resistant staphylococci, Enterococcus faecalis, most extended spectrum beta-lactamase-non-producing Enterobacteriales and Pseudomonas aeruginosa. It may replace use of this associations for PEAT. We compared ceftobiprole to vancomycin plus cefepime, vancomycin plus third generation cephalosporin (e.g. cefotaxime or ceftriaxone) and vancomycin plus piperacillin–tazobactam in this setting
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