What are the recommendations for the route (intravenous (IV) vs. oral (PO)) and duration of postoperative antibiotic treatment when a one-stage revision arthroplasty is performed for subacute or chronic shoulder periprosthetic joint infection (PJI) of the shoulder caused by an indolent organism (e.g., C. acnes or coagulase-negative Staphylococcus)?

Author: Vahid Entezari
RECOMMENDATION: Prior to identifi cation of pathogenic organisms from intraoperative cultures, a course of oral antibiotics may be initiated that covers the potential organism until intraoperative cultures are fi nalized. If the cultures are positive and periprosthetic infection is diagnosed, then a continued course of antibiotics (up to six weeks) should be pursued. There is no evidence to support a preferred route (PO vs. IV), type and
duration of antibiotic treatment.
LEVEL OF EVIDENCE: Consensus
DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)