11/21/2022 0 Comments Dair ortho![]() aureus represent the leading causative pathogen in infections associated with orthopaedic implants, exhibiting remarkable virulence, particularly in patients with multiple comorbidities, and being involved in both early-onset and delayed- or late-onset cases. aureus (MRSA) strains may account for 25–50% of isolates. Furthermore, it is important to recognize the resistance pattern of involved pathogens, considering that methicillin-resistant S. Causative pathogens consist of virulent microorganisms (e.g., Staphylococcus aureus, Enterococcus spp., Gram-negative bacilli) in case of early-onset infections, while low-virulence pathogens, e.g., coagulase-negative staphylococci (CoNS), Propionibacterium acnes, are mostly involved in delayed- and late-onset infections. Infections associated with orthopaedic implants, especially prosthetic joint infections (PJIs), are commonly classified as early-onset, delay-onset, and late-onset infections, with infections occurring in the first 3 months, between 3 and 12–24 months, or after 24 months, respectively. The implementation of a multidisciplinary taskforce and close cooperation between microbiologists and clinicians is crucial for providing the best care in this scenario. The aim of this multidisciplinary opinion article is to summarize evidence supporting the use of the different anti-staphylococcal agents in terms of microbiological and pharmacological optimization according to bone penetration, anti-biofilm activity, long-term safety, and feasibility for outpatient regimens, and to provide a useful guide for clinicians in the management of patients affected by staphylococcal infections associated with orthopaedic implants Novel long-acting lipoglycopeptides, and particularly dalbavancin, alone or in combination with rifampicin, could represent the best antibiotic choice according to real-world evidence and pharmacokinetic/pharmacodynamic properties. Antibiotic bone penetration, anti-biofilm activity, long-term safety, and drug choice/dosage regimens favouring outpatient management (i.e., long-acting or oral agents) play a major role in regards to the chronic evolution of these infections. The wide variety of clinical scenarios encountered in the heterogeneous world of infections associated with orthopaedic implants makes the implementation of an optimal and standardized antimicrobial treatment challenging. It does not store any personal data.Infections associated with orthopaedic implants represent a major health concern characterized by a remarkable incidence of morbidity and mortality. ![]() The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. The cookie is used to store the user consent for the cookies in the category "Performance". This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. The cookies is used to store the user consent for the cookies in the category "Necessary". The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The cookie is used to store the user consent for the cookies in the category "Analytics". These cookies ensure basic functionalities and security features of the website, anonymously. ![]() Necessary cookies are absolutely essential for the website to function properly. ![]()
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