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Study: Wait on antibiotic therapy to treat positive cultures after revision elbow arthroplasty
The researchers of this study recommend against antibiotic therapy for patients with positive cultures after revision elbow arthroplasty, according to results published in the Journal of Bone & Joint Surgery.
“On the basis of our experience, our current practice is to consider the following: unexplained early loosening after primary elbow arthroplasty with pain at rest or at night, isolation of a known pathogen, and identity on a solid culture medium,” Andy T. Wee, MBBS, and colleagues wrote in the study. “We withhold antibiotic therapy in the absence of these features, which will be the case in the majority of our patients with an unexpected positive result on intraoperative culture specimens during revision elbow arthroplasty.”
Wee and colleagues analyzed 217 consecutive reverse elbow arthroplasties between 2000 and 2007. Sixteen patients had positive intraoperative cultures with the majority showing either Staphylococcus epidermidis or Propionibacterium acnes infections, according to the abstract.
Of those 16 patients with positive cultures, 12 patients had more than 2 years of follow-up. Ten of the 12 patients were not treated with long-term antibiotics and 9 patients remained infection-free at the latest follow-up. One patient was treated for infection based on early implant loosening and isolation of Staphylococcus epidermidis, according to the abstract.
Disclosure: Wee has no relevant financial disclosures.