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Title of Journal: Clin Orthop Relat Res

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Abbravation: Clinical Orthopaedics and Related Research®

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Springer-Verlag

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DOI

10.1007/bf00488000

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1528-1132

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Prior Use of Antimicrobial Therapy is a Risk Facto

Authors: Davud Malekzadeh Douglas R Osmon Brian D Lahr Arlen D Hanssen Elie F Berbari
Publish Date: 2010/04/17
Volume: 468, Issue: 8, Pages: 2039-2045
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Abstract

Clinical characteristics and control of the infection of patients with culturenegative CN prosthetic joint infection PJI have not been well assessed Prior use of antimicrobial therapy has been speculated but not proven as a risk factor for CNPJIWe performed a retrospective casecontrol study of 135 patients with CN PJI treated between January 1 1985 and December 31 2000 matched with 135 patients with culturepositive CP PJIs control patients during the study period The time to failure of therapy compared between cases and control patients using a KaplanMeier analysisThe use of prior antimicrobial therapy and postoperative wound drainage after index arthroplasty were associated with increased odds of PJI being culturenegative odds ratio 47 95 CI 28–81 and odds ratio 35 95 CI 15–81 respectively The percent ± SE cumulative incidence free of treatment failure at 2 years followup was similar for CN and CP PJI 75 ± 4 and 79 ± 4 respectivelyPrior antimicrobial therapy and postoperative wound drainage were associated with an increased risk of negative cultures among patients with PJI Physicians should critically evaluate the need for antimicrobial therapy before establishing a microbiologic diagnosis of PJI in patients with suspected PJIEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained

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