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Recently, oral versus\u00a0intravenous (IV) antibiotics for bone and joint infection\u00a0trial demonstrated the noninferiority of oral antimicrobial therapy compared to IV, implying that an early transition to oral administration is reasonable. It is likely that the international consensus meeting of musculoskeletal Infections\u00a0and the European Bone and Joint Infection Society\u00a0will consider these findings. However, rising levels of antimicrobial resistance are challenging and recommendations for dealing with multidrug\u2010resistant (MDR) pathogens resistant to oral antibiotics are lacking. This study focuses on establishing guidance towards their management in PJI. From December 2015 to June 2019, patients with MDR pathogens were included in a single\u2010center prospective cohort study and treated with self\u2010administered outpatient parenteral antimicrobial therapy (S\u2010OPAT) based on a two\u2010stage revision strategy. Demographics, pathogens, antimicrobial agents, and outcomes were recorded. A total of 1738 outpatient days in 26 patients were analyzed. The incidence of pathogens resistant to oral antibiotics in PJI was 4%, most frequently encountered were staphylococcus epidermidis. The Kaplan\u2013Meier\u2010estimated infection\u2010free survival after 3 years was 90% (95% confidence interval, 84.6%\u201395.5%). We recorded adverse events in 6 of 54 (11%) S\u2010OPAT episodes (3.45\/1000 S\u2010OPAT days). (i) S\u2010OPAT in two\u2010stage revision arthroplasty to counter increasing numbers of MDR pathogens resistant to oral agents can achieve a high infection eradication rate and (ii) should therefore be taken into account at the next society's consensus treatment updates.<\/jats:p>","DOI":"10.1002\/jor.24906","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T12:11:27Z","timestamp":1605096687000},"page":"320-332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Facing multidrug\u2010resistant pathogens in periprosthetic joint infections with self\u2010administered outpatient parenteral antimicrobial therapy\u2014A prospective cohort study"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-5743","authenticated-orcid":false,"given":"Sven","family":"Frieler","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma 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