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ANTIBIOTIC EXPOSURE AT THE INFECTION SITE IN PERIPROSTHETIC JOINT INFECTIONS

Recruiting
Conditions
Orthopedic infections
Registration Number
NL-OMON20480
Lead Sponsor
Erasmus MC
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
Not specified
Target Recruitment
120
Inclusion Criteria

Age = 18 years.
-Written informed consent has been obtained from the patient
-Suffering from periprosthetic (hip or knee) joint infections and therefore treated with one of the following antibiotics as part of the two-stage arthroplasty exchange:
oIV: vancomycin, flucloxacillin or cefuroxime
oOral: flucloxacillin, clindamycin or co-trimoxazole
-Patients undergoing a two-stage implant exchange of hip or knee with or without antibiotic free interval prior to re-implantation.
-Able and willing to undergo joint punctures and venous blood sampling during and, in case of an antibiotic free interval, at the end of the six-weeks antibiotic treatment.

Exclusion Criteria

-Unable to draw samples for study purposes.
-Language barriers.
-The use of the target antibiotics at the start of study participation (and therefore at the start of the antibiotic treatment as part of the two-stage arthroplasty exchange).
-The use of drugs interacting with the target antibiotics.

Study & Design

Study Type
Observational non invasive
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
To develop a pharmacokinetic (PK) model for the relationship between dosage, blood concentration and infection site concentration, estimating covariates to determine differences in antibiotic concentrations in synovial fluid, synovial tissue and bone between different types of antibiotics and knee versus hip.
Secondary Outcome Measures
NameTimeMethod
1.To develop and validate an analytical method for measuring antibiotic concentrations in synovial fluid, synovial tissue and bone tissue of the affected joint.<br>2.To determine the non-inferiority of oral antibiotics in comparison to intravenous antibiotics with regards to the antibiotic exposure at the site of infection. Antibiotic exposure is measured in antibiotic concentration related to the MIC of the bacteria targeted.<br>3.To determine the non-inferiority of oral antibiotics in comparison to intravenous antibiotics with regard to infection recurrence/success percentage and antibiotic-related side effects<br>4.To determine the added value for antimicrobial-loaded spacers, in relationship to the use of intravenous and oral antibiotics during the two-stage arthroplasty exchange.<br>
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