Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis
PROSPERO registration ID: 367411 Objectives: This systematic review and meta-analysis was conducted to assess the outcome of streptococcal hip and knee prosthetic joint infection (PJI) treated with Debridement, Antibiotics and Implant Retention (DAIR) and to evaluate risk factors associated with fai...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Surgery in Practice and Science |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262023000475 |
| _version_ | 1797690207752945664 |
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| author | Laura M. Gerritsen Henk Scheper Mark G.J. de Boer Jan W. Schoones Rob G.H.H. Nelissen Bart G.C. Pijls |
| author_facet | Laura M. Gerritsen Henk Scheper Mark G.J. de Boer Jan W. Schoones Rob G.H.H. Nelissen Bart G.C. Pijls |
| author_sort | Laura M. Gerritsen |
| collection | DOAJ |
| description | PROSPERO registration ID: 367411 Objectives: This systematic review and meta-analysis was conducted to assess the outcome of streptococcal hip and knee prosthetic joint infection (PJI) treated with Debridement, Antibiotics and Implant Retention (DAIR) and to evaluate risk factors associated with failure. Methods: We conducted a systematic literature search on PubMed, Embase, Web of Science, and Cochrane library from inception until October 2021. Random effects meta-analyses (i.e. relative risk) were used to estimate the success rate at the study level and its association with possible risk factors for failure with a specific focus on the use of rifampicin. Results: 25 observational studies were included, incorporating 1367 patients with streptococcal PJIs treated with DAIR. An overall pooled success rate of 71% (95% confidence interval (95%CI) 64–77%) was found for streptococcal PJI treated with DAIR. Treatment success was 76% (95%CI 62% to 91%) for knee PJI and 58% (95%CI 52% to 65%) for hip PJI. Treatment success differed for patients receiving rifampicin (84%, 95% CI 78% to 90%) compared to patients not receiving rifampicin (74%, 95% CI 63% to 85%), but this effect was no longer present in subsequent meta-analyses. Conclusions: The meta-analysis showed no clear benefit for rifampicin administration after DAIR for streptococcal PJI. Better outcome was observed for knee PJI compared to hip PJI. |
| first_indexed | 2024-03-12T01:56:14Z |
| format | Article |
| id | doaj.art-7c7fbce0c669449cbb3fd81a79e37780 |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-12T01:56:14Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-7c7fbce0c669449cbb3fd81a79e377802023-09-08T04:33:59ZengElsevierSurgery in Practice and Science2666-26202023-09-0114100201Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysisLaura M. Gerritsen0Henk Scheper1Mark G.J. de Boer2Jan W. Schoones3Rob G.H.H. Nelissen4Bart G.C. Pijls5Department of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, J-11-R-83, Leiden 2333 ZA, The Netherlands; Corresponding authorDepartment of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The NetherlandsDepartment of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The NetherlandsDirectorate of Research Policy (formerly: Walaeus Library), Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The NetherlandsDepartment of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, J-11-R-83, Leiden 2333 ZA, The NetherlandsDepartment of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, J-11-R-83, Leiden 2333 ZA, The NetherlandsPROSPERO registration ID: 367411 Objectives: This systematic review and meta-analysis was conducted to assess the outcome of streptococcal hip and knee prosthetic joint infection (PJI) treated with Debridement, Antibiotics and Implant Retention (DAIR) and to evaluate risk factors associated with failure. Methods: We conducted a systematic literature search on PubMed, Embase, Web of Science, and Cochrane library from inception until October 2021. Random effects meta-analyses (i.e. relative risk) were used to estimate the success rate at the study level and its association with possible risk factors for failure with a specific focus on the use of rifampicin. Results: 25 observational studies were included, incorporating 1367 patients with streptococcal PJIs treated with DAIR. An overall pooled success rate of 71% (95% confidence interval (95%CI) 64–77%) was found for streptococcal PJI treated with DAIR. Treatment success was 76% (95%CI 62% to 91%) for knee PJI and 58% (95%CI 52% to 65%) for hip PJI. Treatment success differed for patients receiving rifampicin (84%, 95% CI 78% to 90%) compared to patients not receiving rifampicin (74%, 95% CI 63% to 85%), but this effect was no longer present in subsequent meta-analyses. Conclusions: The meta-analysis showed no clear benefit for rifampicin administration after DAIR for streptococcal PJI. Better outcome was observed for knee PJI compared to hip PJI.http://www.sciencedirect.com/science/article/pii/S2666262023000475 |
| spellingShingle | Laura M. Gerritsen Henk Scheper Mark G.J. de Boer Jan W. Schoones Rob G.H.H. Nelissen Bart G.C. Pijls Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis Surgery in Practice and Science |
| title | Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis |
| title_full | Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis |
| title_fullStr | Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis |
| title_full_unstemmed | Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis |
| title_short | Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis |
| title_sort | outcome of debridement antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666262023000475 |
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