Tsikopoulos K, Sidiropoulos K. Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery? World J Orthop 2024; 15(5): 483-485 [PMID: 38835680 DOI: 10.5312/wjo.v15.i5.483]
Corresponding Author of This Article
Konstantinos Tsikopoulos, PhD, Senior Researcher, Department of Orthopaedics, Portsmouth Hospitals NHS University Trust, Portsmouth University Hospitals, Cosham, Portsmouth PO6 3LY, United Kingdom. kostastsikop@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2024; 15(5): 483-485 Published online May 18, 2024. doi: 10.5312/wjo.v15.i5.483
Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?
Konstantinos Tsikopoulos, Department of Orthopaedics, Portsmouth Hospitals NHS University Trust, Portsmouth University Hospitals, Portsmouth PO6 3LY, United Kingdom
Konstantinos Sidiropoulos, Emergency Department, Papageorgiou General Hospital of Thessaloniki, Thessaloniki 54635, Greece
Konstantinos Sidiropoulos, Medical School, University of Patras, Patras 26504, Greece
Author contributions: Tsikopoulos K had the original idea; Sidiropoulos K performed the related research and wrote the letter; Tsikopoulos K revised the letter.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Konstantinos Tsikopoulos, PhD, Senior Researcher, Department of Orthopaedics, Portsmouth Hospitals NHS University Trust, Portsmouth University Hospitals, Cosham, Portsmouth PO6 3LY, United Kingdom. kostastsikop@gmail.com
Received: January 14, 2024 Revised: April 1, 2024 Accepted: April 19, 2024 Published online: May 18, 2024 Processing time: 121 Days and 19.2 Hours
Abstract
The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach, as per the International Consensus Meeting 2018 on Musculoskeletal Infection. A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review (2023) on diagnosing, managing, and treating periprosthetic knee infections. However, a significant lack of literature exists concerning the optimal duration for the antibiotic holiday, calling for more research before establishing any clinical guidelines.
Core Tip: Optimising the outcomes of the two-stage revision process for infected hip and knee arthroplasty patients is a crucial topic to address. We wish to highlight that there is no evidence against the use of continuous antibiotic treatment in two-stage septic hip and knee joint arthroplasty. Furthermore, the optimal duration of antibiotic holidays has yet to be determined.
