Which antibiotic(s) should be added to a cement spacer in patients with periprosthetic joint infections (PJIs) caused by multiresistant organisms?

Authors: Valeriy Murylev, Matt hew W. Squire, Lars Frommelt, Solmaz Saleri, Justin Greiner
RECOMMENDATION: In the case of PJIs caused by methicillin-resistant Staphylococcus aureus/methicillin-resistant Staphylococcus epidermidis (MRSA/MRSE), vancomycin should be added to the bone cement spacer. In vancomycin-resistant strains, such as vancomycin-resistant Enterococcus (VRE), or in multiresistant gram-negative PJI cases, individual decision making is mandatory based on the known susceptibilities.
Consultation with a microbiologist/infectious disease specialist is strongly recommended.
LEVEL OF EVIDENCE: Moderate
DELEGATE VOTE: Agree: 99%, Disagree: 0%, Abstain: 1% (Unanimous, Strongest Consensus)

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