Oral vs Intravenous Antibiotics for Treatment of Periprosthetic Joint Infection

Summary

Management of periprosthetic joint infection (PJI) commonly includes 6 weeks of intravenous (IV) antibiotics after surgical treatment. However, there is little evidence to suggest that oral (PO) therapy results in worse outcomes. This study aims to determine whether or not PO antibiotics are non-inferior to IV antibiotics in treating PJI. The study is a multicenter, parallel-group, randomized (1 : 1), open-label, non-inferiority trial. The non-inferiority margin will be set at 10%. Adults with a clinical diagnosis of PJI according to the International Consensus Meeting (ICM) criteria who would ordinarily receive at least 6 weeks of antibiotics and have received ≤ 7 days of IV therapy from surgery will be included. A total of 308 participants will be centrally computer-randomized to PO or IV antibiotics to complete the first 6 weeks of therapy. Follow-on PO therapy will be permitted in either arm. The primary outcome is the proportion of participants experiencing treatment failure within 1 year. An associated cost-effectiveness evaluation including complications, resource utilization and quality-of-life data will be performed.

Eligibility

Age range

18+ years

Sex

All

Healthy volunteers

Yes

Interventions

• Drug
  Bactrim

  Bactrim will be given for 6 weeks to treat joint infection

• Drug
  Cefadroxil

  Cefadroxil will be given for 6 weeks to treat joint infection

• Drug
  Doxycycline Hcl

  Doxycycline HCl will given for 6 weeks to treat joint infection

• Drug
  Clindamycin

  Clindamycin will given for 6 weeks to treat joint infection

Location