Arthritis, Septic
Conditions
Keywords
septic arthritis, surgery, antibiotic duration, remission, sequelae
Brief summary
The optimal duration of systemic antibiotic administration for native joint septic arthritis is unknown. The investigators perform a randomized study allowing up to 3 surgical lavages and allocating patients into a two-week's and a four week's randomization arm
Detailed description
The optimal duration of systemic antibiotic administration for native joint septic arthritis is unknown. The investigators perform a randomized study allocating patients into a two-week's and a four week's randomization arm. The adult patients are hospitalized for septic arthritis. A computer program randomizes 1:1 between a two week's and a four week's arm of targeted antibiotic treatment of which at least the first week is intravenously. The randomization may occur until Day 5 of admission. Up to three surgical interventions are allowed. The investigators allow the inclusion of all bacterial arthritis and all joints.
Interventions
PROCEDURETwo week's arm - surgery
The investigators perform a surgical drainage of the infection along with the complete removal of the infected orthopedic implant.
PROCEDUREFour week's arm - surgery
The investigators perform a surgical drainage of the infection along with the complete removal of the infected orthopedic implant.
DRUGTwo week's arm - drugs
After the surgical implant removal, the investigators prescribe a total of 2 weeks of systemic targeted antibiotic therapy against the causative pathogen(s), of which one week is recommended to be intravenously.
DRUGFour week's arm - drugs
After the surgical implant removal, the investigators prescribe a total of 4 weeks of systemic targeted antibiotic therapy against the causative pathogen(s), of which one week is recommended to be intravenously.
Sponsors
University Hospital, Geneva
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 120 Years
Healthy volunteers
No
Inclusion criteria
1. Age \>17 years 2. Microbiologically-confirmed septic arthritis 3. At least one surgical drainage/lavage
Exclusion criteria
1. Presence of osteosynthesis material in the vicinity of the articulation 2. Presence of a concomitant infection needing more than 2 week's of antibiotic therapy 3. More than 3 surgical drainages 4. Life expectancy less than 6 months 5. Chronic osteomyelitis in vicinity of the arthritis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Remission of systemic infection | 6 months | Measurement of fever. |
| Sequels | 6 months | Patient's remaining gait disorders. * range of movement in adjacent joints of former infection * questionnaire regarding persistant pain and handicaps (open wording) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Wound redness | 6 months | Visual examination of the presence of wound redness. |
| Wound discharge | 6 months | Visual examination of the presence of wound discharge |
| Presence of pus | 6 months | Visual examination of the presence of pus coming out the wound |
Countries
Switzerland
Outcome results
None listed