Sistema de Salut de Catalunya
Institut Català de la Salut
[Tevell S] Department of Infectious Diseases, Karlstad Hospital, Karlstad, Sweden. School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden. [Aboltins C] Department of Infectious Diseases, Northern Health, Melbourne, Australia. Department of Medicine, The University of Melbourne, Melbourne, Australia. [Hewlett A] Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA. [Rodriguez-Pardo D] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBERINFEC, ISCIII-CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. [Young B] Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
Vall d'Hebron Barcelona Hospital Campus
2025-08-25T07:17:11Z
2025-08-25T07:17:11Z
2025-09
Fluoroquinolones; Periprosthetic joint infections; Efficacy
Fluoroquinolones; Infeccions articulars periprotètiques; Eficàcia
Fluoroquinolonas; Infecciones articulares periprotésicas; Eficacia
Background Fluoroquinolones (FQs) are currently recommended for the treatment of periprosthetic joint infections (PJIs) caused by staphylococci and Gram-negative bacteria (GNB) in patients undergoing debridement, antibiotics and implant retention (DAIR). In recent decades, reports of serious adverse events associated with FQ use have led to official regulatory recommendations for their restricted use. This review aims to describe the evidence for, and discuss the risks and benefits of, FQ use for PJI. Methods A comprehensive search of MEDLINE and EMBASE up to October 2024 was conducted using pre-defined criteria to identify studies addressing (i) the efficacy of FQs in treating staphylococcal and GNB-PJI, and (ii) serious adverse events associated with FQs. A narrative synthesis of the results was performed. Results No randomized controlled trials were identified. A total of 19 retrospective studies were reviewed to assess the efficacy of FQs in treating staphylococcal and GNB-PJI, though the sample sizes in these studies were relatively small. Fifty-seven studies, mostly large retrospective epidemiological cohorts, were found evaluating adverse events associated with FQ treatment. Conclusions There is evidence supporting the use of FQ monotherapy for GNB-PJI and FQ combined with rifampin for staphylococcal PJIs following DAIR over other antimicrobial regimens. There is evidence that FQs are associated with an increased risk of tendinopathy, prolonged QTc interval, peripheral neuropathy and dysglycaemia, however the absolute risk is low. When FQs are used in the treatment of PJIs, an individualized risk assessment and close monitoring during treatment are recommended.
S.T. is supported by the Research committee of Region Värmland (LIVFOU) and by grants from the Swedish state under the ALF agreement between the Swedish government and the county councils (Region Örebro County, Sweden OLL-967677). B.Y. is supported by the National institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC).
Article
Published version
English
Articulacions artificials; Malalties bacterianes - Tractament; Estafilococs; Medicaments antibacterians - Ús terapèutic - Efectes secundaris; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Prostheses and Implants::Joint Prosthesis; Other subheadings::Other subheadings::Other subheadings::/adverse effects; DISEASES::Bacterial Infections and Mycoses::Infection::Prosthesis-Related Infections; ORGANISMS::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus; CHEMICALS AND DRUGS::Heterocyclic Compounds::Heterocyclic Compounds, Fused-Ring::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones::Fluoroquinolones; Other subheadings::Other subheadings::Other subheadings::/adverse effects; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::prótesis e implantes::prótesis articulares; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos; ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones relacionadas con prótesis; ORGANISMOS::Bacteria::bacterias formadoras de endosporas::bacterias grampositivas formadoras de endosporas::bacilos grampositivos formadores de endosporas::Staphylococcaceae::Staphylococcus; COMPUESTOS QUÍMICOS Y DROGAS::compuestos heterocíclicos::compuestos heterocíclicos con anillos de fusión::compuestos heterocíclicos de 2 anillos::quinolinas::quinolonas::fluoroquinolonas; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos
Elsevier
CMI Communications;2(3)
https://doi.org/10.1016/j.cmicom.2025.105103
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
