Antibiotic prophylaxis in orthopedic prosthetic surgery.

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Abstract

[Indexed for MEDLINE] 18. Lakartidningen. 2019 Oct 21;116:FR6C. [Treatment of orthopedic implant-associated infections]. [Article in Swedish] Tevell S(1), Christensson B(2), Nilsdotter-Augustinsson Å(3), Rydén C(4), Ryding U(5), Söderquist B(6), Åkerlund B(7). Author information: (1)Infektionskliniken, Centralsjukhuset i Karlstad - Centrum för Klinisk Forskning, Region Värmland Karlstad, Sweden - Infektionskliniken Karlstad, Sweden. (2)avd. för Infektionsmedicin, Lunds Universitet - Lund, Sweden avd. för Infektionsmedicin, Lunds Universitet - Lund, Sweden. (3)Infektionskliniken Region Östergötland, Vrinnevisjukhuset Norrköping - Norrköping, Sweden Infektionskliniken Region Östergötland, Vrinnevisjukhuset Norrköping - Norrköping, Sweden. (4)Infektionskliniken Helsingborgs lasarett - Helsingborg, Sweden Infektionskliniken Helsingborgs lasarett - Helsingborg, Sweden. (5)Infektionskliniken Östersunds sjukhus - Östersund, Sweden Infektionskliniken Östersunds sjukhus - Östersund, Sweden. (6)Örebro Universitet Institutionen för Medicinska Vetenskaper - Infektionskliniken, Universitetssjukhuset i Örebro Orebro, Sweden Laboratoriemedicinska länskliniken - Klinisk Mikrobiologi Örebro, Sweden. (7)Karolinska Institutet Institutionen för medicin Huddinge - Enheten för Infektionssjukdomar, Karolinska Universitetssjukhuset Huddinge/Stockholm Huddinge, Sweden Karolinska Institutet Institutionen för medicin Huddinge - Enheten för Infektionssjukdomar, Karolinska Universitetssjukhuset Huddinge/Stockholm Huddinge, Sweden. The Swedish National Guidelines for Bone and Joint Infections were revised during 2018. The work was carried out on behalf of the Swedish Society for Infectious Diseases. The study group consists of senior consultants in infectious diseases, supported by specialists in orthopedic surgery, clinical microbiology and allergology when needed. The study group emphasizes that implant associated infections are challenging and requires multidisciplinary cooperation, including, but not limited to, specialists in orthopedic surgery, infectious diseases, clinical microbiology and radiology for optimal treatment results. All aspects of the clinical management are equally important; selecting the optimal antibiotic prophylaxis in arthroplasty as well as fracture surgery, early diagnosis of infection, adequate treatment, follow-up, and finally a structured evaluation of outcome. Profound and updated knowledge of treatment of biofilm related infection is necessary to achieve optimal results in patients with implant-associated infections. Future challenges include improved decision support for combining surgical treatment with selection of proper antibiotics, as well as management of antibiotic resistance, drug-drug interactions and adverse effects of antibiotic treatment.