Oral Antibiotic Therapy for Bone and Joint Infections: Challenging an Intravenous Dogma

In a randomized, controlled trial, oral antibiotic therapy during the first 6 weeks was noninferior to intravenous therapy.

A central tenet in infectious disease is that complicated orthopedic infections require at least 4 to 6 weeks of intravenous antibiotic therapy; however, the associated cost and complications are a source of increasing concern. Investigators in the U.K. performed a noninferiority trial to assess 1-year outcomes of oral versus intravenous antibiotic therapy in patients receiving treatment for bone or joint infection. Participants were randomized to 6 weeks of either intravenous or oral antibiotic therapy within 7 days of surgery or the start of antibiotic therapy. Selection of specific agents was at the individual physician's discretion, as was continuation of antibiotics beyond 6 weeks.

Among 1054 patients (mean age, 60), 61% had metalware-r…

Reviewing Author

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Oral Antibiotic Therapy for Bone and Joint Infections: Challenging an Intravenous Dogma

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Reviewing Author