{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:27:29Z","timestamp":1789644449414,"version":"4.0.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Microbiology Laboratory and the Orthopaedic Service"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal duration of antibiotic therapy for treating orthopaedic implant infections after surgical drainage and complete implant removal is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single-centre, unblinded, prospective trial randomizing (1:1) eligible patients to either 4 or 6\u2009weeks of systemic, pathogen-targeted antibiotic therapy. Clinical trial registration number: ClinicalTrials.gov (NCT0362209).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed 123 eligible patients (62 in the 4\u2009week antibiotic arm and 61 in the 6\u2009week arm) in the ITT analysis. The patients\u2019 median age was 64\u2009years, 75 (61%) were men and 38 (31%) were immunocompromised. The most common types of infection treated included: two-stage exchange procedure for prosthetic joint infection (n\u205f=\u205f38); orthopaedic plate infection (44) and infected nail implants (11). The median duration of post-explant intravenous antibiotic therapy was 4\u2009days. Overall, 120 episodes (98%) were cured microbiologically and 116 (94%) clinically after a median follow-up period of 2.2\u2009years. During follow-up, four patients had a clinical recurrence with a pathogen other than the initial causative agent. We noted recurrence of clinical infection in four patients in the 4\u2009week arm and three patients in the 6\u2009week arm (4\/62 versus 3\/61; \u03c72 test; P\u205f=\u205f0.74); in all cases, this occurred at around 2\u2009months following the end of antibiotic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no statistically significant difference in the rates of clinical or microbiological remission between patients randomized to only 4 compared with 6\u2009weeks of systemic antibiotic therapy after removal of an infected osteoarticular implant.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkz202","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T19:16:20Z","timestamp":1555614980000},"page":"2394-2399","source":"Crossref","is-referenced-by-count":52,"title":["Four versus six weeks of antibiotic therapy for osteoarticular infections after implant removal: a randomized trial"],"prefix":"10.1093","volume":"74","author":[{"given":"Mohamed","family":"Benkabouche","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Racloz","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Service, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland"},{"name":"Orthopaedic Service of Surgery, Pourtales Hospital, Neuch\u00e2tel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Spechbach","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A","family":"Lipsky","sequence":"additional","affiliation":[{"name":"Service of Infectious 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