Multisite Study of the Management of Musculoskeletal Infection After Trauma: The MMUSKIT Study.

Background

The optimal duration and choice of antibiotic for fracture-related infection (FRI) is not well defined. This study aimed to determine whether antibiotic duration (≤6 vs >6 weeks) is associated with infection- and surgery-free survival. The secondary aim was to ascertain risk factors associated with surgery- and infection-free survival.

Methods

We performed a multicenter retrospective study of patients diagnosed with FRI between 2013 and 2022. The association between antibiotic duration and surgery- and infection-free survival was assessed by Cox proportional hazard models. Models were weighted by the inverse of the propensity score, calculated with a priori variables of hardware removal; infection due to

Results

Of 96 patients, 54 (56.3%) received ≤6 weeks of antibiotics and 42 (43.7%) received >6 weeks. There was no association between longer antibiotic duration and surgery-free survival (hazard ratio [HR], 0.95; 95% CI, .65-1.38;

Conclusions

The ideal duration of antibiotics to treat FRI is unclear. In this multicenter study, there was no association between antibiotic treatment duration and surgery- or infection-free survival.

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. J. L. S. receives royalties from UptoDate as a content expert for pelvic osteomyelitis; received support for attending the IDWeek 2023 meeting to speak about prosthetic joint infection; and has been compensated as an expert witness for 3M, Woods Rogers Vandevenier Black PLC, Frith & Ellerman Law Firm, and Ross Feller & Casey for litigation related to prosthetic joint infection. A. S. R. declares a grant from the National Institutes of Health National Institute on Alcohol Abuse and Alcoholism (project 1UH2AA026214-01) and personal fees from DynaMed Plus as a topic editor. M. R. D. receives stock or stock options from Azra Care, NSite, Reselute; receives intellectual property royalties from Osteocentric, Reselute, Shukla, and UptoDate; is a paid consultant for Synthes, Next Science, Resulute, Shukla, and SI Bone; has research support from DePuy, a Johnson & Johnson Company; and is a board or committee member for the Orthopaedic Trauma Association. L. C. received support for this manuscript from the University of Utah, Department of Orthopaedics; received payment for expert testimony by Horn, Aylward, and Brandy for medical malpractice cases involving infected fracture fixation; and serves as a board member for the Musculoskeletal Infection Society. S. B. N. receives royalties from UptoDate for bone and joint infection and skin and soft tissue infection topics; received payment for the Infectious Diseases Board Review Course (George Washington CME); received support for attending the IDWeek 2023 meeting to speak on antibiotic suppression in prosthetic joint infections; is a member of the education committee for the Musculoskeletal Infection Society; and received stock options for Sonoran Biosciences in 2018. All other authors report no potential conflicts.