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Stahl JP, Canouï E, Bleibtreu A, Dubée V, Ferry T, Gillet Y, Lemaignen A, Lesprit P, Lorrot M, Lourtet-Hascoët J, Manaquin R, Meyssonnier V, Pavese P, Pham TT, Varon E, Gauzit R. SPILF update on bacterial arthritis in adults and children. Infect Dis Now 2023; 53:104694. [PMID: 36948248 DOI: 10.1016/j.idnow.2023.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
In 2020 the French Society of Rhumatology (SFR) published an update of the 1990 recommendations for management of bacterial arthritis in adults. While we (French ID Society, SPILF) totally endorse this update, we wished to provide further information about specific antibiotic treatments. The present update focuses on antibiotics with good distribution in bone and joint. It is important to monitor their dosage, which should be maximized according to PK/PD parameters. Dosages proposed in this update are high, with the optimized mode of administration for intravenous betalactams (continuous or intermittent infusion). We give tools for the best dosage adaptation to conditions such as obesity or renal insufficiency. In case of enterobacter infection, with an antibiogram result "susceptible for high dosage", we recommend the requesting of specialized advice from an ID physician. More often than not, it is possible to prescribe antibiotics via the oral route as soon as blood cultures are sterile and clinical have symptoms shown improvement. Duration of antibiotic treatment is 6 weeks for Staphylococcus aureus, and 4 weeks for the other bacteria (except for Neisseria: 7 days).
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Affiliation(s)
- J P Stahl
- Université Grenoble Alpes, Maladies Infectieuses, 38700, France.
| | - E Canouï
- Equipe mobile d'infectiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence des Infections Ostéo-Articulaires complexes (CRIOAc Cochin) APHP-CUP, Paris, France
| | - A Bleibtreu
- Maladies Infectieuseset Tropicales, Hôpital Pitié Salpêtrière, AP-HP Sorbonne Université, Paris France
| | - V Dubée
- Maladies Infectieuses et Tropicales, CHU d'Angers, Angers, France
| | - T Ferry
- Maladies Infectieuses et Tropicales, Centre de Référence des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 69004, Hospices Civils de Lyon, Lyon, France. Service des Maladies Infectieuses, Département de médecine, Hôpitaux Universitaires de Genève, Suisse
| | - Y Gillet
- Urgences et Réanimation Pédiatrique, Hospices Civils de Lyon, Université Claude Bernard Lyon, France
| | - A Lemaignen
- Maladies Infectieuses, CHRU de Tours, Université de Tours, 37044, France
| | - P Lesprit
- Maladies Infectieuses, CHU Grenoble Alpes, 38043, France
| | - M Lorrot
- Pédiatrie Générale et Equipe Opérationnelle d'Infectiologie, Centre de Référence des Infections Ostéo-Articulaires complexes (CRIOAc Pitié), Hôpital Armand Trousseau AP-HP Sorbonne Université, Paris France
| | | | - R Manaquin
- Maladies Infectieuses et Tropicales, GHSR , CHU de La Réunion, CRAtb La Réunion, Saint-Pierre, 97410, FRANCE
| | - V Meyssonnier
- Centre de Référence des Infections Ostéo-articulaires, GH Diaconesses Croix Saint-Simon, 75020, Paris, France; Service de Médecine Interne Générale, Département de médecine, Hôpitaux Universitaires de Genève, Suisse
| | - P Pavese
- Maladies Infectieuses, CHU Grenoble Alpes, 38043, France
| | - T-T Pham
- Maladies Infectieuses et Tropicales, Centre de Référence des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 69004, Hospices Civils de Lyon, Lyon, France. Service des Maladies Infectieuses, Département de médecine, Hôpitaux Universitaires de Genève, Suisse
| | - E Varon
- Centre National de Référence des Pneumocoques, CRC-CRB, Centre Hospitalier Intercommunal de Créteil, 94000, Créteil, France
| | - R Gauzit
- Equipe mobile d'infectiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence des Infections Ostéo-Articulaires complexes (CRIOAc Cochin) APHP-CUP, Paris, France
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Couderc M, Bart G, Coiffier G, Godot S, Seror R, Ziza JM, Coquerelle P, Darrieutort-Laffite C, Lormeau C, Salliot C, Veillard E, Bernard L, Baldeyrou M, Bauer T, Hyem B, Touitou R, Fouquet B, Mulleman D, Flipo RM, Guggenbuhl P. 2020 French recommendations on the management of septic arthritis in an adult native joint. Joint Bone Spine 2020; 87:538-547. [PMID: 32758534 DOI: 10.1016/j.jbspin.2020.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/22/2022]
Abstract
Septic arthritis (SA) in an adult native joint is a rare condition but a diagnostic emergency due to the morbidity and mortality and the functional risk related to structural damage. Current management varies and the recommendations available are dated. The French Rheumatology Society (SFR) Bone and Joint Infection Working Group, together with the French Language Infectious Diseases Society (SPILF) and the French Orthopaedic and Trauma Surgery Society (SOFCOT) have worked according to the HAS methodology to devise clinical practice recommendations to diagnose and treat SA in an adult native joint. One new focus is on the importance of microbiological documentation (blood cultures and joint aspiration) before starting antibiotic treatment, looking for differential diagnoses (microcrystal detection), the relevance of a joint ultrasound to guide aspiration, and the indication to perform a reference X-ray. A cardiac ultrasound is indicated only in cases of SA involving Staphylococcus aureus, oral streptococci, Streptococcus gallolyticus or Enterococcus faecalis, or when infective endocarditis is clinically suspected. Regarding treatment, we stress the importance of medical and surgical collaboration. Antibiotic therapies (drugs and durations) are presented in the form of didactic tables according to the main bacteria in question (staphylococci, streptococci and gram-negative rods). Probabilistic antibiotic therapy should only be used for patients with serious symptoms. Lastly, non-drug treatments such as joint drainage and early physical therapy are the subject of specific recommendations.
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Affiliation(s)
- Marion Couderc
- Rheumatology Department, Gabriel-Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Géraldine Bart
- Rheumatology Department, South Hospital, Rennes University Hospital, Rennes, France; Western France Reference Centre for Complex Bone and Joint Infections (CRIOGO), Rennes, France
| | - Guillaume Coiffier
- Rheumatology Department, South Hospital, Rennes University Hospital, Rennes, France; Western France Reference Centre for Complex Bone and Joint Infections (CRIOGO), Rennes, France.
| | - Sophie Godot
- Rheumatology Department, Diaconesses Croix Saint-Simon Hospital Group, Paris, France; Greater Paris Reference Centre for Joint and Bone Infections (IOA-IDF), Paris, France
| | - Raphaele Seror
- Rheumatology Department, Le Kremlin-Bicêtre Hospital, AP-HP, South Paris, France
| | - Jean-Marc Ziza
- Rheumatology Department, Diaconesses Croix Saint-Simon Hospital Group, Paris, France; Greater Paris Reference Centre for Joint and Bone Infections (IOA-IDF), Paris, France
| | - Pascal Coquerelle
- Nephrology-Rheumatology Department, Bethune Hospital, Bethune, France
| | | | | | - Carine Salliot
- Rheumatology Department, Orléans Regional Hospital, Orléans, France
| | - Eric Veillard
- Rheumatology Practice, 6, rue des 4 Pavillons, 35400 Saint-Malo, France
| | - Louis Bernard
- Infectious Diseases Department, Bretonneau Hospital, Tours University Hospital, Tours, France; Western France Reference Centre for Complex Bone and Joint Infections (CRIOGO), Rennes, France
| | - Marion Baldeyrou
- Infectious Diseases Department, Pontchaillou Hospital, Rennes University Hospital, Rennes, France; Western France Reference Centre for Complex Bone and Joint Infections (CRIOGO), Rennes, France
| | - Thomas Bauer
- Orthopaedic and Trauma Surgery Department, Ambroise-Paré Hospital, AP-HP, West Paris, France; Greater Paris Reference Centre for Joint and Bone Infections (IOA-IDF), Paris, France
| | - Beate Hyem
- Biomedical Analysis Laboratory, Microbiology, Diaconesses Croix Saint-Simon Hospital Group, Paris, France; Greater Paris Reference Centre for Joint and Bone Infections (IOA-IDF), Paris, France
| | - Robert Touitou
- General Medical Practice, 3, avenue du Bel Air, 75012 Paris, France
| | - Bernard Fouquet
- Physical Medicine and Rehabilitation Department, Trousseau Hospital, Tours, France
| | - Denis Mulleman
- Rheumatology Department, Bretonneau Hospital, Tours University Hospital, Tours, France
| | - René-Marc Flipo
- Rheumatology Department, Salengro Hospital, Lille University Hospital, Lille, France
| | - Pascal Guggenbuhl
- Rheumatology Department, South Hospital, Rennes University Hospital, Rennes, France; Western France Reference Centre for Complex Bone and Joint Infections (CRIOGO), Rennes, France
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