Is there a role for direct intra-articular antibiotic infusion following irrigation and debridement (I&D) for periprosthetic joint infection (PJI)?

Authors: Leo Whiteside, Briande Beaubien, Kimberly E. Martin, Christopher Ferry
RECOMMENDATION: The concept of achieving a minimum biofilm eradication concentration (MBEC) of antibiotics at the site of the infection is compelling. Despite the presence of retrospective studies reporting favorable outcome, because of heterogeneity in terms of adjunctive antibiotics, absence of a control group and small cohort size, the routine administration of intra-articular antibiotics in treatment of PJI is not justifi ed.
Prospective, randomized controlled trials (RCTs) are needed to support the routine use of intra-articular antibiotics as a stand-alone or adjunct treatment of PJI.
LEVEL OF EVIDENCE: Consensus
DELEGATE VOTE: Agree: 92%, Disagree: 6%, Abstain: 2% (Super Majority, Strong Consensus)

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