Antibiotic duration in native and periprosthetic joint infections : a systematic review and meta-analysis of randomized controlled trials.

Study Summary

12 randomized controlled trials including 1414 patients with native septic arthritis or periprosthetic joint infection (PJI) were included in this systematic review and meta-analysis comparing short vs long-course antibiotic therapy. Pooled outcomes of interest included treatment failure, uncontrolled infection, complications, and mortality. Long-course antibiotic therapy significantly reduced treatment failure in PJI, whereas short-course therapy achieved comparable infection control in native septic arthritis when combined with adequate surgical drainage. Complication and mortality rates were generally similar between treatment durations. These findings suggest that antibiotic duration should be individualized according to joint type and surgical strategy, with prolonged therapy favoured for periprosthetic joint infections and shorter courses appropriate for many native joint infections.