Short-Term Outcomes of Phage-Antibiotic Combination Treatment in Adult Patients with Periprosthetic Hip Joint Infection

Implant-associated infections are the most costly problem in modern orthopedics due to the continued increase in the occurrence of antibiotic-resistant bacterial strains that requires the development of new effective antimicrobials. A non-randomized, prospective, open-label, with historical control...

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Veröffentlicht in:Viruses Jg. 15; H. 2; S. 499
Hauptverfasser: Fedorov, Eugeny, Samokhin, Alexander, Kozlova, Yulia, Kretien, Svetlana, Sheraliev, Taalai, Morozova, Vera, Tikunova, Nina, Kiselev, Alexey, Pavlov, Vitaliy
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 10.02.2023
MDPI
Schlagworte:
Adult
adults
Anti-Bacterial Agents - therapeutic use
Antibiotic resistance
Antibiotics
Antimicrobial agents
Arthritis, Infectious
Artificial hip joints
Bacteria
Bacteriophages
Biofilms
Care and treatment
Clinical practice guidelines
Complications and side effects
confidence interval
Dosage and administration
Drug resistance
Evaluation
Hip Joint
hip joint infection
Humans
Joint diseases
Joint surgery
odds ratio
Orthopedics
Pathogens
Patient outcomes
Patients
periprosthetic
Phage therapy
Phages
PJI
Postoperative Complications
Prospective Studies
relapse
Research centers
Retrospective Studies
Staphylococcus infections
surgery
Surgical wound infections
Russia
periprosthetic
phage therapy
orthopedics
antibiotics
hip joint infection
PJI
surgery
ISSN:1999-4915, 1999-4915
Online-Zugang:Volltext
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Zusammenfassung:Implant-associated infections are the most costly problem in modern orthopedics due to the continued increase in the occurrence of antibiotic-resistant bacterial strains that requires the development of new effective antimicrobials. A non-randomized, prospective, open-label, with historical control study on the use of combined phage/antibiotic therapy of periprosthetic joint infection (PJI) was carried out. Forty-five adult patients with deep PJI of the hip joint were involved in the study, with a 12-month follow-up after one-stage revision surgery. Patients from a prospective study group (SG, n = 23) were treated with specific phage preparation and etiotropic antibiotics, whereas patients from a retrospective comparator group (CG, n = 22) received antibiotics only. The rate of PJI relapses in the SG was eight times less than that in the CG: one case (4.5%) versus eight cases (36.4%), p = 0.021. The response rate to treatment was 95.5% (95% confidence interval (CI) = 0.7511–0.9976) in the SG and only 63.6% (95% CI = 0.4083–0.8198) in the CG. The odds ratio for PJI relapse in patients of the SG was 0.083 (95% CI = 0.009–0.742), which was almost 12 times lower than that in the CG. The obtained results support the efficacy of the combined phage-antibiotic treatment of PJI.
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ISSN:1999-4915
1999-4915
DOI:10.3390/v15020499