Proposed Guidelines for the Management of ESBL in Prosthetic Joint Infections

Infect Disord Drug Targets. 2020;20(5):563-569. doi: 10.2174/1871526519666190613121936.

Abstract

The aim of this paper is to establish guidelines for the management of extendedspectrum beta-lactamases (ESBL) associated prosthetic joint infections (PJI). This study reviewed 21 patients in the literature documented with ESBL associated PJI. Literature suggests that patients with ESBL PJI are stratified into either early infections (<3 weeks) or late infections (>3 weeks), for which, appropriate laboratory and imaging studies need to be completed. Favorable outcomes require a two-stage revision with an antibiotic-impregnated spacer and a prolonged course of intravenous carbapenem antibiotic.

Keywords: Extended-spectrum beta-lactamases; antibiotic; carbapenem; infections; intravenous; prosthetic joint infections.

Publication types

  • Review

MeSH terms

  • Administration, Intravenous
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Carbapenems / administration & dosage
  • Carbapenems / therapeutic use
  • Combined Modality Therapy
  • Drug Resistance, Multiple, Bacterial
  • Enterobacteriaceae Infections / therapy*
  • Female
  • Humans
  • Infusions, Intralesional
  • Joint Prosthesis / microbiology*
  • Male
  • Practice Guidelines as Topic
  • Prosthesis-Related Infections / therapy*
  • Reoperation / instrumentation*
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • Carbapenems