{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:27:33Z","timestamp":1788845253443,"version":"build-2803163510"},"reference-count":11,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Literature on periprosthetic joint infection (PJI) contains varying strategies and definitions of suppressive antimicrobial therapy (SAT). This study aimed to describe current SAT strategies, evaluate their clinical outcomes, and establish a consensus definition of SAT for research and clinical purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed by searching PubMed and EMBASE from their inception to 10 March 2025. All trials and observational studies including \u226510 patients with PJI treated with SAT were eligible. Data on study, patient, and treatment characteristics, definitions, and outcomes were extracted. Study quality was appraised using the Methodological Index for Non-Randomized Studies tool. A random effects model was used to pool success rates. Definitions were developed through a modified Delphi process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-two studies (N = 2524 patients) were included: 25 from the United States and 17 from Europe. In US literature, SAT was predominantly prescribed for acute PJI managed with debridement, antibiotics, and implant retention (DAIR), whereas European studies primarily involved PJI managed without curative intent. The pooled reported success rate of SAT was 74% (95% confidence interval [CI], 63%\u201385%) for acute PJI treated with DAIR and 70% (95% CI, 63%\u201378%) for chronic PJI treated with DAIR or without surgery. Definitions of SAT were inconsistently reported. Consensus was achieved, resulting in definitions distinguishing SAT from extended antimicrobial therapy (EAT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Suppressive antimicrobial therapy is inconsistently defined in PJI literature with variation of practice between the United States and Europe. To harmonize research and clinical communication, we advocate the use of consensus definitions of SAT and EAT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag251","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:41:47Z","timestamp":1775821307000},"source":"Crossref","is-referenced-by-count":1,"title":["Practice Variation, Outcomes, and Definitions of Suppressive Antimicrobial Therapy for Prosthetic Joint Infections: A Systematic Review and Expert Consensus Statement"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9898-7960","authenticated-orcid":false,"given":"Jaap L J","family":"Hanssen","sequence":"first","affiliation":[{"name":"Leiden University Center for Infectious Diseases (LUCID), Infectious Diseases, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Pijls","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7866-2467","authenticated-orcid":false,"given":"Marjan","family":"Wouthuyzen-Bakker","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-5351","authenticated-orcid":false,"given":"Laurens","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Fiona Stanley Hospital , Murdoch, Washington ,","place":["Australia"]},{"name":"Medical School, University Western Australia , Perth, Washington ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Wakefield Orthopaedic Clinic , Adelaide, South Australia ,","place":["Australia"]},{"name":"Centre for Orthopaedic and Trauma Research, University of Adelaide , Adelaide, South Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4544-4807","authenticated-orcid":false,"given":"Joffrey","family":"van Prehn","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases (LUCID), Medical Microbiology and Infection Control, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2762-0878","authenticated-orcid":false,"given":"Andy O","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Hospital for Special Surgery , NewYork, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrica M J","family":"van der Linden","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6302-9471","authenticated-orcid":false,"given":"Nicol\u00e1s W","family":"Cort\u00e9s-Penfield","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Nebraska Medical Center , Omaha, Nebraska ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9374-0811","authenticated-orcid":false,"given":"Alex","family":"Soriano","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Cl\u00ednic of Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5009-6499","authenticated-orcid":false,"given":"Mark G J","family":"de Boer","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases (LUCID), Infectious Diseases, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]},{"name":"Department of Clinical Epidemiology, Leiden University Medical Center , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9737-7546","authenticated-orcid":false,"given":"Henk","family":"Scheper","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases (LUCID), Infectious Diseases, Leiden University Medical Center , Leiden ,","place":["The 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