What are the indications for utilizing fosfomycin, tigecycline and daptomycin, either instead of other antibiotics or in conjunction with other antibiotics, for the management of periprosthetic joint infections (PJIs)?

What are the indications for utilizing fosfomycin, tigecycline and daptomycin, either instead of other antibiotics or in conjunction with other antibiotics, for the management of periprosthetic joint infections (PJIs)?

Authors: Jose L. Del Pozo, Alex Soriano, Laura Morata

RECOMMENDATION FOR DAPTOMYCIN: Daptomycin is an alternative treatment for patients with PJIs caused by methicillin-resistant Staphylococcus aureus (MRSA).

LEVEL OF EVIDENCE: Moderate

RECOMMENDATION FOR FOSFOMYCIN: Although there is no clinical experience using fosfomycin in PJIs, it could be considered in infections due to multi-drug resistant gram-positive (MDR-GP) or gram-negative bacteria (GNB) as a part of a combination regimen with daptomycin, rifampin or tigecycline when the microorganism is susceptible.

LEVEL OF EVIDENCE: Limited

RECOMMENDATION FOR TIGEYCYLINE: Tigecycline could be considered for the treatment of MDR-GP or -GNB as a part of a combination regimen when the microorganism is susceptible.

LEVEL OF EVIDENCE: Limited

DELEGATE VOTE: Agree: 86%, Disagree: 4%, Abstain: 10% (Super Majority, Strong Consensus)

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