ArticlePloS one2019
Changing perioperative prophylaxis during antibiotic therapy and iterative debridement for orthopedic infections?
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05502380 (Broad-spectrum Antibiotic Prophylaxis in Tumor and Infected Orthopedic Sur-gery - the Prospective-randomized, Microbiologist-blinded, Stratified, Superiority Trials - BAPTIST Trials), which is not on this map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Broad-spectrum Antibiotic Prophylaxis in Tumor and Infected Orthopedic Sur-gery - the Prospective-randomized, Microbiologist-blinded, Stratified, Superiority Trials - BAPTIST Trials
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Trial
- Pathogen-Specific Risk for Iterative Surgical Debridement in Orthopedic Infections: A Prospective Multicohort Analysis.Journal of clinical medicine · 2025Article
- Evaluating the Link Between Postoperative Timing of Rifampicin Introduction and the Clinical and Microbiological Outcomes of Orthopedic Staphylococcal Implant Infections.Antibiotics (Basel, Switzerland) · 2025Article
- The Performance of Gram-Staining in Tailoring the Empirical Antibiotic Choice in Operated Diabetic Foot Infections.Journal of clinical medicine · 2025Article
- Antimicrobials in Orthopedic Infections: Overview of Clinical Perspective and Microbial Resistance.Medicina (Kaunas, Lithuania) · 2024Review
- Preoperative Antibiotic Administration Does Not Improve the Outcomes of Operated Diabetic Foot Infections.Antibiotics (Basel, Switzerland) · 2024Article
- Transmission of Staphylococcus aureus in the anaesthesia work area has greater risk of association with development of surgical site infection when resistant to the prophylactic antibiotic administered for surgery.The Journal of hospital infection · 2023Observational
- Timing of Revascularization and Parenteral Antibiotic Treatment Associated with Therapeutic Failures in Ischemic Diabetic Foot Infections.Antibiotics (Basel, Switzerland) · 2023Article
- Risk Factors for Surgical Site Infections in Elective Orthopedic Foot and Ankle Surgery: The Role of Diabetes Mellitus.Journal of clinical medicine · 2023Article
- Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge.Journal of bone and joint infection · 2022Review
- The draining surgical wound post total hip and knee arthroplasty: what are my options? A narrative review.EFORT open reviews · 2021Review
- Treating Diabetic Foot Osteomyelitis: A Practical State-of-the-Art Update.Medicina (Kaunas, Lithuania) · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerioperative antibiotic prophylaxis in non-infected orthopedic surgery is evident, in contrast to prophylaxis during surgery for infection. Epidemiological data are lacking for this particular situation. METHODS AND
findingsIt is a single-center cohort on iterative surgical site infections (SSIs) in infected orthopedic patients. We included 2480 first episodes of orthopedic infections (median age 56 years and 833 immune-suppressed): implant-related infections (n = 648), osteoarticular infections (1153), and 1327 soft tissue infections. The median number of debridement was 1 (range, 1-15 interventions). Overall, 1617 infections (65%) were debrided once compared to 862 cases that were operated multiple times (35%). Upon iterative intraoperative tissue sampling, we detected pathogens in 507 cases (507/862; 59%), of which 241 (242/507; 48%) corresponded to the initial species at the first debridement. We witnessed 265 new SSIs (11% of the cohort) that were resistant to current antibiotic therapy in 174 cases (7% of the cohort). In multivariate analysis, iterative surgical debridements that were performed under current antibiotic administration were associated with new SSIs (odds ratio 1.6, 95%CI 1.2-2.2); mostly occurring after the 2nd debridement. However, we failed to define an ideal hypothetic prophylaxis during antibiotic therapy to prevent further SSIs.
conclusionsSelection of new pathogens resistant to ongoing antibiotic therapy occurs frequently during iterative debridement in orthopedic infections, especially after the 2nd debridement. The new pathogens are however unpredictable. The prevention, if feasible, probably relies on surgical performance and wise indications for re-debridement instead of new maximal prophylactic antibiotic coverage in addition to current therapeutic regimens.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.