Antibiotic Suppression in the Infected Total Knee Arthroplasty


Microorganism

Antibiotic

Three times daily

Two times daily

Once time daily

MS S. aureus

MS coagulase-negative Staphylococcus

Streptococcus spp.

Propionibacterium acnes

Amoxicillin/clavulanic acid 500–800/125 mg

X
  
Clindamycin 300 mg

X
  
TMP-SMX 800/160 mg
 
X
 
Doxycycline 100 mg
 
X
 
Levofloxacin 500 mg
  
X

MR S. aureus

MR coagulase-negative

Staphylococcus

Corynebacterium spp.

Clindamycin 300 mg

X
  
TMP-SMX 800/160 mg
 
X
 
Doxycycline 100 mg
 
X
 
Enterobacteriaceae

Amoxicillin/clavulanic acid 500–800/125 mg
   
TMP-SMX 800/160 mg
   
Doxycycline 100 mg
   
Ciprofloxacin 500 mg
     
X
 
Pseudomonas spp.

Ciprofloxacin 500 mg
 
X
 
Anaerobics

Clindamycin 300 mg

X
  
Metronidazol 500 mg
 
X
 


Table 15.1 shows some practical examples of adequate chronic antibiotic suppression for some specific microorganisms. Of course, the possibilities of potential infectious agents and treatments are very much wider.

Another controversial aspect of antibiotic suppression is the length of treatment. Some authors did not include patients treated with less than 6 months of antibiotic suppression [1, 46]. Therefore, we must ensure that antibiotic suppression for patients that are not able to undergo surgery will last as long as the life of patients [17].

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Mar 10, 2018 | Posted by in ORTHOPEDIC | Comments Off on Antibiotic Suppression in the Infected Total Knee Arthroplasty
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