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)

hk141