Innovations and Management of Patients with Bone and Joint Infections: Anti-Infectious Therapies to Keep the Function!
Seance of wednesday 12 february 2020 (Les jeunes orthopédistes)
DOI number : 10.26299/36ys-cb79/emem.2018.4.007
Abstract
Objective: To describe innovative approaches that may help to improve the prognosis of bone and joint infection (BJI). Indeed, the burden of BJI is considerable, and largely underestimated, especially in patients with chronic infection.
Methods: Based on the 10-year experience of our dedicated reference regional center and based on physiopathological data, we point out in these memories the crucial points that have been set up to 2020, and these that have to be developed.
Results: In France, a nation-wide network called CRIOAc has been created and funded by the French Health ministry to manage complex BJI. It allows to identify the potential interest of: (i) antibiotic loaded bone substitutes in patients with chronic osteomyelitis or septic non-union; (ii) suppressive oral or subcutaneous antimicrobial therapy that could be used in patients with chronic prosthetic-joint infection; (iii) the use of particular agents that have the ability to target the bacteria embedded in biofilm such as bacteriophages and phage lysins.
Conclusion: This multistep approach is probably a key determinant to propose innovative management in patients with complex BJI, to improve the outcome. The next step will be to evaluate such practices in nation-wide clinical trials.
Methods: Based on the 10-year experience of our dedicated reference regional center and based on physiopathological data, we point out in these memories the crucial points that have been set up to 2020, and these that have to be developed.
Results: In France, a nation-wide network called CRIOAc has been created and funded by the French Health ministry to manage complex BJI. It allows to identify the potential interest of: (i) antibiotic loaded bone substitutes in patients with chronic osteomyelitis or septic non-union; (ii) suppressive oral or subcutaneous antimicrobial therapy that could be used in patients with chronic prosthetic-joint infection; (iii) the use of particular agents that have the ability to target the bacteria embedded in biofilm such as bacteriophages and phage lysins.
Conclusion: This multistep approach is probably a key determinant to propose innovative management in patients with complex BJI, to improve the outcome. The next step will be to evaluate such practices in nation-wide clinical trials.