#67 – Nixing the Nidus: Managing Retained Sources in Prosthetic Joint Infections

Dr. Laura Certain (@laura_certain) and Dr. Nico Cortes-Penfield (@Cortes_Penfield) join Dr. Julie Ann Justo (@julie_justo) to discuss all things related to prosthetic joint infections. Tune in to learn about what comprises a bacterial biofilm, how it develops, and ways to combat it using the latest evidence-based antibiotic regimens. We also take a look at what’s on the horizon for the field of orthopedic infectious diseases.
 
References:
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  2. Bernard L, et al. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med. 2021 May 27;384(21):1991-2001. doi: 10.1056/NEJMoa2020198. PMID: 34042388. (DATIPO trial)
  3. Gallagher C, et al. Impact of Implementing an IV to PO Antibiotic Treatment Protocol for Orthopedic Infections ion Prescribing Habits and Health Utilization Outcomes. IDWeek 2022. Poster 909.
  4. Febrile Podcast. Episode #31 – Truth or DAIR. 2022 Feb 28. https://febrilepodcast.com/episode-31-truth-or-dair/
  5. Frank JM, et al. The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial. Clin Orthop Relat Res. 2017 Jan;475(1):56-61. doi: 10.1007/s11999-016-4890-4. PMID: 27387759.
  6. Kelly MP, et al. Extended Oral Antibiotics Increase Bacterial Resistance in Patients Who Fail 2-Stage Exchange for Periprosthetic Joint Infection. J Arthroplasty. 2022 Aug;37(8S):S989-S996. doi: 10.1016/j.arth.2022.01.027. PMID: 35074446.
  7. Payne J, et al. Inducing Antimicrobial Resistance with Long-term Antibiotics at Stage 2 Revision for Periprosthetic Joint Infection. IDWeek 2022. Poster 981.
  8. Frost P, et al. Phototoxic potential of minocycline and doxycycline. Arch Dermatol. 1972 May;105(5):681-3. PMID: 5026677.
  9. Lode H, et al. Comparative pharmacokinetics of cephalexin, cefaclor, cefadroxil, and CGP 9000. Antimicrob Agents Chemother. 1979 Jul;16(1):1-6. doi: 10.1128/AAC.16.1.1. PMID: 475366.
  10. Sader HS, et al. In vitro activity of cefpodoxime compared with other oral cephalosporins tested against 5556 recent clinical isolates from five medical centers. Diagn Microbiol Infect Dis. 1993 Aug-Sep;17(2):143-50. doi: 10.1016/0732-8893(93)90025-3. PMID: 8243035.
  11. Green S & Tsai YV. Precision Dosing of To-Marrow: Linezolid Therapeutic Drug Monitoring. ContagionLive: Bench to Bedside with SIDP. 2022 Nov 3. https://www.contagionlive.com/view/precision-dosing-of-to-marrow-linezolid-therapeutic-drug-monitoring
 
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Laura Certain, MD, PhD

Dr. Laura Certain is a clinical assistant professor of medicine in the Division of Infectious Diseases and an adjunct assistant professor of orthopedics at the University of Utah. She also served as the president of the MusculoSkeletal Infection Society in 2022.

Nico Cortes-Penfield, MD, FACP, FIDSA

Dr. Nico Cortes-Penfield is an assistant professor of infectious diseases at the University of Nebraska Medical Center and also serves as the medical director of their Outpatient Parenteral Antimicrobial Therapy Program. He joined UNMC in 2019 and is one of the two core faculty for their orthopedic ID service line. He has a specific interest in the management of periprosthetic joint infections and trauma hardware infections.

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