Is there a role for nonoperative suppressive treatment in the management of subacute or chronic shoulder periprosthetic joint infection (PJI)?

Author: Anders Ekelund
RECOMMENDATION: Although there is a role for suppressive antibiotic treatment of selected cases of periprosthetic infection of the shoulder, there are only a few shoulders included in the published literature. The vast majority of published cases describe initial irrigation and debridement, and these are not well separated in the literature from the small number of cases of patients treated with antibiotics alone. No patient treated with antibiotics alone for shoulder PJI has had antibiotics stopped and remained infection-free, thus concerns related to effi cacy, longterm toxicity and development of resistant strains are paramount with this strategy. No recommendations can be given on indication, type and
duration of suppressive antibiotic treatment.
LEVEL OF EVIDENCE: Limited
DELEGATE VOTE: Agree: 96%, Disagree: 0%, Abstain: 4% (Unanimous, Strongest Consensus)