Two weeks targeted antibiotic therapy superior to four weeks of therapy in Septic Arthritis
Two weeks targeted antibiotic therapy superior to four weeks of therapy in Septic Arthritis, revealed a study published in the journal Annals of Rheumatic Disease.
Septic arthritis is also known as infectious arthritis and is usually caused by bacteria. It can also be caused by a virus or fungus. The condition is an inflammation of a joint that's caused by infection. Typically, septic arthritis affects one large joint in the body, such as the knee or hip. The optimal duration of post-surgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.
The authors of the study conducted a prospective, unblinded, randomized, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant-related infections, episodes without surgical lavage and episodes with a follow-up of fewer than 2 months. A total of 154 cases: 77 in the 4-week arm and 77 in the 2-week arm were enrolled for the study.
- Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate).
- There was no difference in the number of adverse events or sequelae between the study arms.
- Of the overall 154 arthritis cases, 99 concerned the hand and wrist, for which an additional subgroup analysis was performed.
- In this per-protocol subanalysis, we noted three recurrences: one in the 2-week arm (97 % cure); two in the 4-week arm (96 % cure) and witnessed sequelae in 50% in the 2-week arm versus 55% in the 4-week arm, of which five (13%) and six (13%) needed further interventions.
Based on their results the authors concluded that after initial surgical lavage for septic arthritis, 2 weeks of targeted antibiotic therapy is not inferior to 4 weeks regarding cure rate, adverse events or sequelae and leads to a significantly shorter hospital stay, at least for hand and wrist arthritis.
Gjika E et al. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: A prospective, randomised, non-inferiority trial. Ann Rheum Dis 2019 Aug; 78:1114. (https://doi.org/10.1136/annrheumdis-2019-215116)