Extended Oral Antibiotics and Infection Prophylaxis after a Primary or Revision Total Knee Arthroplasty

Abstract

One of the most common reasons for failure of primary total knee arthroplasty and need for revision surgery is periprosthetic infection. Antibiotics are one of the mainstays of treatment to address prosthetic joint infections, but the route of administration and timing of delivery to optimize patient outcomes are debated. This article reviews the use and attributes of commonly used oral antibiotics, especially extended or long-term utilization, as prophylaxis and treatment for prosthetic joint infections in a primary or revision total knee arthroplasty, which include debridement, antibiotics, and implant retention, one-stage and two-stage exchange arthroplasty.

Keywords

total joint arthroplasty - prosthetic joint infection - oral prophylactic antibiotics

• References

• 1 Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. Patient satisfaction after total knee replacement: a systematic review. HSS J 2018; 14 (02) 192-201
• 2 Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty 2012; 27 (8, Suppl): 61-65.e1
• 3 Bozic KJ, Kurtz SM, Lau E. , et al. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop Relat Res 2010; 468 (01) 45-51
• 4 Wouthuyzen-Bakker M, Nijman JM, Kampinga GA, van Assen S, Jutte PC. Efficacy of antibiotic suppressive therapy in patients with a prosthetic joint infection. J Bone Jt Infect 2017; 2 (02) 77-83
• 5 Khanna V, Tushinski DM, Soever LJ, Vincent AD, Backstein DJ. Above knee amputation following total knee arthroplasty: when enough is enough. J Arthroplasty 2015; 30 (04) 658-662
• 6 Gomez-Urena EO, Tande AJ, Osmon DR, Berbari EF. Diagnosis of prosthetic joint infection: cultures, biomarker and criteria. Infect Dis Clin North Am 2017; 31 (02) 219-235
• 7 Parvizi J, Tan TL, Goswami K. , et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 2018; 33 (05) 1309-1314.e2
• 8 Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004; 351 (16) 1645-1654
• 9 Boyle KK, Wood S, Tarity TD. Low-virulence organisms and periprosthetic joint infection-biofilm considerations of these organisms. Curr Rev Musculoskelet Med 2018; 11 (03) 409-419
• 10 Tande AJ, Patel R. Prosthetic joint infection. Clin Microbiol Rev 2014; 27 (02) 302-345
• 11 Bozhkova S, Tikhilov R, Labutin D. , et al. Failure of the first step of two-stage revision due to polymicrobial prosthetic joint infection of the hip. J Orthop Traumatol 2016; 17 (04) 369-376
• 12 Cha MS, Cho SH, Kim DH. , et al. Two-stage total knee arthroplasty for prosthetic joint infection. Knee Surg Relat Res 2015; 27 (02) 82-89
• 13 Lum ZC, Natsuhara KM, Shelton TJ, Giordani M, Pereira GC, Meehan JP. Mortality during total knee periprosthetic joint infection. J Arthroplasty 2018; 33 (12) 3783-3788
• 14 Li C, Renz N, Trampuz A. Management of periprosthetic joint infection. Hip Pelvis 2018; 30 (03) 138-146
• 15 Rao N, Crossett LS, Sinha RK, Le Frock JL. Long-term suppression of infection in total joint arthroplasty. Clin Orthop Relat Res 2003; (414) 55-60
• 16 Siqueira MB, Saleh A, Klika AK. , et al. Chronic suppression of periprosthetic joint infections with oral antibiotics increases infection-free survivorship. J Bone Joint Surg Am 2015; 97 (15) 1220-1232
• 17 O'Hara LM, Thom KA, Preas MA. Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): a summary, review, and strategies for implementation. Am J Infect Control 2018; 46 (06) 602-609
• 18 O'Toole P, Osmon D, Soriano A. , et al. Oral antibiotic therapy. J Orthop Res 2014; 32 (Suppl. 01) S152-S157
• 19 Osmon DR, Berbari EF, Berendt AR. , et al; Infectious Diseases Society of America. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2013; 56 (01) e1-e25
• 20 Li HK, Rombach I, Zambellas R. , et al; OVIVA Trial Collaborators. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med 2019; 380 (05) 425-436
• 21 Cyriac JM, James E. Switch over from intravenous to oral therapy: a concise overview. J Pharmacol Pharmacother 2014; 5 (02) 83-87
• 22 Landersdorfer CB, Bulitta JB, Kinzig M, Holzgrabe U, Sörgel F. Penetration of antibacterials into bone: pharmacokinetic, pharmacodynamic and bioanalytical considerations. Clin Pharmacokinet 2009; 48 (02) 89-124
• 23 Agwuh KN, MacGowan A. Pharmacokinetics and pharmacodynamics of the tetracyclines including glycylcyclines. J Antimicrob Chemother 2006; 58 (02) 256-265
• 24 Aboltins CA, Page MA, Buising KL. , et al. Treatment of staphylococcal prosthetic joint infections with debridement, prosthesis retention and oral rifampicin and fusidic acid. Clin Microbiol Infect 2007; 13 (06) 586-591
• 25 Greenberg RN, Kennedy DJ, Reilly PM. , et al. Treatment of bone, joint, and soft-tissue infections with oral ciprofloxacin. Antimicrob Agents Chemother 1987; 31 (02) 151-155
• 26 El Helou OC, Berbari EF, Lahr BD. , et al. Efficacy and safety of rifampin containing regimen for staphylococcal prosthetic joint infections treated with debridement and retention. Eur J Clin Microbiol Infect Dis 2010; 29 (08) 961-967
• 27 Puhto AP, Puhto T, Niinimäki T, Ohtonen P, Leppilahti J, Syrjälä H. Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention. Int Orthop 2015; 39 (09) 1785-1791
• 28 Zimmerli W, Widmer AF, Blatter M, Frei R, Ochsner PE. ; Foreign-Body Infection (FBI) Study Group. Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. JAMA 1998; 279 (19) 1537-1541
• 29 Doernberg SB, Winston LG, Deck DH, Chambers HF. Does doxycycline protect against development of Clostridium difficile infection?. Clin Infect Dis 2012; 55 (05) 615-620
• 30 Thamlikitkul V, Danpakdi K, Chokloikaew S. Incidence of diarrhea and Clostridium difficile toxin in stools from hospitalized patients receiving clindamycin, beta-lactams, or nonantibiotic medications. J Clin Gastroenterol 1996; 22 (02) 161-163
• 31 Pea F, Furlanut M, Cojutti P. , et al. Therapeutic drug monitoring of linezolid: a retrospective monocentric analysis. Antimicrob Agents Chemother 2010; 54 (11) 4605-4610
• 32 Pradier M, Nguyen S, Robineau O. , et al. Suppressive antibiotic therapy with oral doxycycline for Staphylococcus aureus prosthetic joint infection: a retrospective study of 39 patients. Int J Antimicrob Agents 2017; 50 (03) 447-452
• 33 Pradier M, Robineau O, Boucher A. , et al. Suppressive antibiotic therapy with oral tetracyclines for prosthetic joint infections: a retrospective study of 78 patients. Infection 2018; 46 (01) 39-47
• 34 Yassien M, Khardori N, Ahmedy A, Toama M. Modulation of biofilms of Pseudomonas aeruginosa by quinolones. Antimicrob Agents Chemother 1995; 39 (10) 2262-2268
• 35 Shah NB, Osmon DR, Steckelberg JM. , et al. Pseudomonas prosthetic joint infections: a review of 102 episodes. J Bone Jt Infect 2016; 1: 25-30
• 36 Pushkin R, Iglesias-Ussel MD, Keedy K. , et al. A randomized study evaluating oral fusidic acid (CEM-102) in combination with oral rifampin compared with standard-of-care antibiotics for treatment of prosthetic joint infections: a newly identified drug-drug interaction. Clin Infect Dis 2016; 63 (12) 1599-1604
• 37 Thompson JM, Saini V, Ashbaugh AG. , et al. Oral-only linezolid-rifampin is highly effective compared with other antibiotics for periprosthetic joint infection: study of a mouse model. J Bone Joint Surg Am 2017; 99 (08) 656-665
• 38 Peel TN, Buising KL, Dowsey MM. , et al. Outcome of debridement and retention in prosthetic joint infections by methicillin-resistant staphylococci, with special reference to rifampin and fusidic acid combination therapy. Antimicrob Agents Chemother 2013; 57 (01) 350-355
• 39 Nijland HM, Ruslami R, Suroto AJ. , et al. Rifampicin reduces plasma concentrations of moxifloxacin in patients with tuberculosis. Clin Infect Dis 2007; 45 (08) 1001-1007
• 40 Zeller V, Dzeing-Ella A, Kitzis MD, Ziza JM, Mamoudy P, Desplaces N. Continuous clindamycin infusion, an innovative approach to treating bone and joint infections. Antimicrob Agents Chemother 2010; 54 (01) 88-92
• 41 Laffer RR, Graber P, Ochsner PE, Zimmerli W. Outcome of prosthetic knee-associated infection: evaluation of 40 consecutive episodes at a single centre. Clin Microbiol Infect 2006; 12 (05) 433-439
• 42 Gómez J, Canovas E, Baños V. , et al. Linezolid plus rifampin as a salvage therapy in prosthetic joint infections treated without removing the implant. Antimicrob Agents Chemother 2011; 55 (09) 4308-4310
• 43 Rao N, Ziran BH, Hall RA, Santa ER. Successful treatment of chronic bone and joint infections with oral linezolid. Clin Orthop Relat Res 2004; (427) 67-71
• 44 Razonable RR, Osmon DR, Steckelberg JM. Linezolid therapy for orthopedic infections. Mayo Clin Proc 2004; 79 (09) 1137-1144
• 45 Stein A, Bataille JF, Drancourt M. , et al. Ambulatory treatment of multidrug-resistant Staphylococcus-infected orthopedic implants with high-dose oral co-trimoxazole (trimethoprim-sulfamethoxazole). Antimicrob Agents Chemother 1998; 42 (12) 3086-3091
• 46 San Juan R, Garcia-Reyne A, Caba P. , et al. Safety and efficacy of moxifloxacin monotherapy for treatment of orthopedic implant-related staphylococcal infections. Antimicrob Agents Chemother 2010; 54 (12) 5161-5166
• 47 Thompson S, Townsend R. Pharmacological agents for soft tissue and bone infected with MRSA: which agent and for how long?. Injury 2011; 42 (Suppl. 05) S7-S10
• 48 Rodríguez-Pardo D, Pigrau C, Lora-Tamayo J. , et al; REIPI Group for the Study of Prosthetic Infection. Gram-negative prosthetic joint infection: outcome of a debridement, antibiotics and implant retention approach. A large multicentre study. Clin Microbiol Infect 2014; 20 (11) O911-O919
• 49 Tornero E, Morata L, Martínez-Pastor JC. , et al. Importance of selection and duration of antibiotic regimen in prosthetic joint infections treated with debridement and implant retention. J Antimicrob Chemother 2016; 71 (05) 1395-1401
• 50 Odum SM, Fehring TK, Lombardi AV. , et al; Periprosthetic Infection Consortium. Irrigation and debridement for periprosthetic infections: does the organism matter?. J Arthroplasty 2011; 26 (6, Suppl): 114-118
• 51 Pappas PG, Kauffman CA, Andes DR. , et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 62 (04) e1-e50
• 52 Henk E, Brian D, Ian S. , et al. Can short term (two weeks or less) antibiotic treatment be considered following resection arthroplasty for chronic periprosthetic joint infections (PJIs)? Proceedings of the International Consensus Meeting on Prosthetic Joint Infection. Philadelphia 2018. Part II-Hip and Knee: 500–501. Available at: https://icmphilly.com/wpcontent/uploads/2018/11/Hip-and-Knee.pdf . Accessed December 15, 2018
• 53 Enzler MJ, Berbari E, Osmon DR. Antimicrobial prophylaxis in adults. Mayo Clin Proc 2011; 86 (07) 686-701
• 54 Berríos-Torres SI, Umscheid CA, Bratzler DW. , et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017; 152 (08) 784-791
• 55 Yates Jr AJ. ; American Association of Hip and Knee Surgeons Evidence-Based Medicine Committee. Postoperative prophylactic antibiotics in total joint arthroplasty. Arthroplast Today 2018; 4 (01) 130-131
• 56 Ryan SP, Kildow BJ, Tan TL, Parvizi J, Bolognesi MP, Seyler TM. ; American Association of Hip and Knee Surgeons Research Committee. Is there a difference in infection risk between single and multiple doses of prophylactic antibiotics? A meta-analysis. Clin Orthop Relat Res 2019; 477 (07) 1577-1590
• 57 Tan TL, Shohat N, Rondon AJ. , et al. Perioperative antibiotic prophylaxis in total joint arthroplasty: a single dose is as effective as multiple doses. J Bone Joint Surg Am 2019; 101 (05) 429-437
• 58 Inabathula A, Dilley JE, Ziemba-Davis M. , et al. Extended oral antibiotic prophylaxis in high-risk patients substantially reduces primary total hip and knee arthroplasty 90-day infection rate. J Bone Joint Surg Am 2018; 100 (24) 2103-2109
• 59 Bert JM, Hooper J, Moen S. Outpatient total joint arthroplasty. Curr Rev Musculoskelet Med 2017; 10 (04) 567-574
• 60 Kolisek FR, McGrath MS, Jessup NM, Monesmith EA, Mont MA. Comparison of outpatient versus inpatient total knee arthroplasty. Clin Orthop Relat Res 2009; 467 (06) 1438-1442
• 61 Berger RA, Kusuma SK, Sanders SA, Thill ES, Sporer SM. The feasibility and perioperative complications of outpatient knee arthroplasty. Clin Orthop Relat Res 2009; 467 (06) 1443-1449
• 62 Bovonratwet P, Ondeck NT, Nelson SJ, Cui JJ, Webb ML, Grauer JN. Comparison of outpatient vs inpatient total knee arthroplasty: an ACS-NSQIP analysis. J Arthroplasty 2017; 32 (06) 1773-1778
• 63 Parvizi J, Mui A, Purtill JJ, Sharkey PF, Hozack WJ, Rothman RH. Total joint arthroplasty: when do fatal or near-fatal complications occur?. J Bone Joint Surg Am 2007; 89 (01) 27-32
• 64 Namba RS, Inacio MC, Paxton EW. Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am 2013; 95 (09) 775-782
• 65 Basques BA, Tetreault MW, Della Valle CJ. Same-day discharge compared with inpatient hospitalization following hip and knee arthroplasty. J Bone Joint Surg Am 2017; 99 (23) 1969-1977
• 66 Esposito S, Leone S, Noviello S. , et al; Registro Nazionale OPAT. Outpatient parenteral antibiotic therapy in the elderly: an Italian Observational Multicenter Study. J Chemother 2009; 21 (02) 193-198
• 67 Seaton RA, Ritchie ND, Robb F, Stewart L, White B, Vallance C. From ‘OPAT’ to ‘COpAT’: implications of the OVIVA study for ambulatory management of bone and joint infection. J Antimicrob Chemother 2019; 74 (08) 2119-2121
• 68 Kuiper JW, Vos SJ, Saouti R. , et al. Prosthetic joint-associated infections treated with DAIR (debridement, antibiotics, irrigation, and retention): analysis of risk factors and local antibiotic carriers in 91 patients. Acta Orthop 2013; 84 (04) 380-386
• 69 Kuiper JW, Willink RT, Moojen DJ, van den Bekerom MP, Colen S. Treatment of acute periprosthetic infections with prosthesis retention: review of current concepts. World J Orthop 2014; 5 (05) 667-676
• 70 Chaussade H, Uçkay I, Vuagnat A. , et al. Antibiotic therapy duration for prosthetic joint infections treated by Debridement and Implant Retention (DAIR): similar long-term remission for 6 weeks as compared to 12 weeks. Int J Infect Dis 2017; 63: 37-42
• 71 Lora-Tamayo J, Euba G, Cobo J. , et al; Prosthetic Joint Infection Group of the Spanish Network for Research in Infectious Diseases—REIPI. Short- versus long-duration levofloxacin plus rifampicin for acute staphylococcal prosthetic joint infection managed with implant retention: a randomised clinical trial. Int J Antimicrob Agents 2016; 48 (03) 310-316
• 72 Puhto AP, Puhto T, Syrjala H. Short-course antibiotics for prosthetic joint infections treated with prosthesis retention. Clin Microbiol Infect 2012; 18 (11) 1143-1148
• 73 Engesæter LB, Dale H, Schrama JC, Hallan G, Lie SA. Surgical procedures in the treatment of 784 infected THAs reported to the Norwegian Arthroplasty Register. Acta Orthop 2011; 82 (05) 530-537
• 74 Haddad FS, Sukeik M, Alazzawi S. Is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections?. Clin Orthop Relat Res 2015; 473 (01) 8-14
• 75 Momin M, Li G, Wang Y, Maimaitiming A, Cao L. Single-stage revision for chronic periprosthetic joint infection of the knee: a minimum 4-year follow-up. Ann Joint 2017; 2 (07) 1-10
• 76 Bialecki J, Bucsi L, Fernando N. , et al. Hip and knee section, treatment, one stage exchange: proceedings of international consensus on orthopedic infections. J Arthroplasty 2019; 34 (2S): S421-S426
• 77 Ford AN, Holzmeister AM, Rees HW, Belich PD. Characterization of outcomes of 2-stage exchange arthroplasty in the treatment of prosthetic joint infections. J Arthroplasty 2018; 33 (7S): S224-S227
• 78 Zywiel MG, Johnson AJ, Stroh DA, Martin J, Marker DR, Mont MA. Prophylactic oral antibiotics reduce reinfection rates following two-stage revision total knee arthroplasty. Int Orthop 2011; 35 (01) 37-42
• 79 Frank JM, Kayupov E, Moric M. , et al; Knee Society Research Group. The Mark Coventry, MD, Award: oral antibiotics reduce reinfection after two-stage exchange: a multicenter, randomized controlled trial. Clin Orthop Relat Res 2017; 475 (01) 56-61
• 80 Saivin S, Houin G. Clinical pharmacokinetics of doxycycline and minocycline. Clin Pharmacokinet 1988; 15 (06) 355-366
• 81 Byren I, Bejon P, Atkins BL. , et al. One hundred and twelve infected arthroplasties treated with ‘DAIR’ (debridement, antibiotics and implant retention): antibiotic duration and outcome. J Antimicrob Chemother 2009; 63 (06) 1264-1271