Joint Infection Clinical Trial
Official title:
Interest in Probabilistic Antibiotic Therapy With Broad-spectrum Beta-lactams in Orthopedic Surgery
The management of Joint Infections (JIs) requires a medical-surgical team which includes rheumatologists, infectious disease specialists, orthopedists as well as microbiologists. This collaboration makes it possible to optimize patient care both from a functional point of view and from an infection point of view. The diagnosis of these infections is based on clinic, imaging and bacteriology (microbiological samples). Treatment is based on surgical treatment and appropriate antibiotic therapy, which will be charged only after the sample has been taken. For non-complex native septic arthritis, identification of the bacteria is expected before starting antibiotic therapy adapted to the germ. For patients requiring surgical treatment: patients with complex native joint infections (comorbidities, allergies, etc.) or joint infections on hardware, the identification of the incriminated germ(s) cannot be expected. Probabilistic antibiotic therapy is then started while awaiting the microbiological results. This antibiotic therapy generally lasts 48 hours, while the results of the antibiogram are known. If for (JIs) on native joints recent recommendations were published by the French society of rheumatology in 2020, it is not the same for (JIs) on hardware. As a result, no updated recommendations indicate the probabilistic antibiotic therapy to prescribe immediately post-operatively. Currently, the old recommendations are no longer applied regarding positive grams. Daptomycin is preferred over vancomycin. On the other hand, for gram-negative germs, broad-spectrum beta-lactams are always prescribed. The investigators are questioning the benefit of these prescriptions given the epidemiological context of joint infections and bacterial resistance phenomena. The investigators hypothesize that osteoarticular infections are mainly due to gram-positive bacteria. By affirming this hypothesis, investigators could avoid prescriptions for broad-spectrum beta-lactams. This would lead to a reduction in patient exposure to broad-spectrum antibiotics (fewer adverse effects, ecological and economic gain).
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT05519007 -
Rate of Total Joint Infection 90-day After Surgery Following Irrigation With Next Science No-Rinse Solution vs SOC Alone
|
N/A | |
| Active, not recruiting |
NCT04563325 -
Oral-only Antibiotics for Bone and Joint Infections in Children
|
Phase 4 | |
| Recruiting |
NCT05341908 -
Prevalence of Pathogens in Synovial Fluid Obtained From Emergency Department Patients
|
||
| Recruiting |
NCT03550911 -
Biological Collection From Samples From The Gut Microbiota In Patients Having A Bone Or Joint Infection Treated By A Suppressive Subcutaneous Antibiotherapy With Betalactamine (CARBAMICROBIOTA)
|
||
| Completed |
NCT04440631 -
Gut Microbiome of Patients Undergoing Antibiotic Therapy for Orthopedic Device-related Infection
|
||
| Recruiting |
NCT05753215 -
Controlled Trial of Omadacycline Randomized Treatment Given for Bone and Joint Infection
|
Phase 2 | |
| Recruiting |
NCT05137314 -
Study in Patients Undergoing Debridement, Antibiotics, and Implant Retention (DAIR) for Treatment of a Periprosthetic Joint Infection (PJI) Occurring After Total Knee Arthroplasty (TKA)
|
Phase 1 | |
| Not yet recruiting |
NCT06293352 -
Real-component vs All-cement Articulating Spacers for Periprosthetic Knee Infection
|
N/A | |
| Recruiting |
NCT04304885 -
Effect of Sonication on Periprosthetic Joint Infection Treatment Strategy.
|
||
| Completed |
NCT03403608 -
Subcutaneous Suppressive Antibiotic Therapy for Bone and Joint Infections
|
N/A | |
| Recruiting |
NCT03704766 -
Alpha-Defensin and Synovial Proteins to Improve Detection of Pediatric Septic Arthritis
|
N/A | |
| Completed |
NCT00974493 -
Oral Versus Intravenous Antibiotics for Bone and Joint Infections (OVIVA B&J)
|
Phase 4 | |
| Completed |
NCT03191292 -
Bacterial Epidemiology and Empirical Antibiotherapy in Patients With Prosthetic Joint Infection
|
N/A | |
| Completed |
NCT05804058 -
Biofilm Composition as a Predictive Biomarker for Prosthetic Joint Infection
|
||
| Enrolling by invitation |
NCT04723940 -
Or v IV Antibiotics for Infection
|
Phase 3 | |
| Completed |
NCT03426761 -
Dalbavancin For The Treatment of Gram Positive Osteoarticular Infections
|
Phase 4 | |
| Enrolling by invitation |
NCT03713528 -
Can Intraosseous Antibiotics Improve the Results of Irrigation & Debridement and Prosthetic Retention for PJI?
|
Phase 4 | |
| Completed |
NCT04948281 -
Joint Infection Following ACL Reconstruction
|
||
| Completed |
NCT06267287 -
Microbiological Structure of Pathogens of Periprosthetic Infection of Large Joints in the Post-Covid Period
|
||
| Terminated |
NCT03335592 -
Cost of Off-label Antibiotics in Osteoarticular Infections
|