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Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit

Background Empirical antibiotic strategies in the treatment of fracture related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis should be based on local microbiological antibiograms. Aim To describe the microbiology and review the antibiogram profiles of bacterial...

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Main Author: Arakkal, Ashley
Other Authors: Laubscher, Maritz
Format: Thesis
Language:English
Published: Division of General Surgery 2024
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access_status_str Open Access
author Arakkal, Ashley
author2 Laubscher, Maritz
author_browse Arakkal, Ashley
Laubscher, Maritz
author_facet Laubscher, Maritz
Arakkal, Ashley
author_sort Arakkal, Ashley
collection Thesis
description Background Empirical antibiotic strategies in the treatment of fracture related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis should be based on local microbiological antibiograms. Aim To describe the microbiology and review the antibiogram profiles of bacterial isolates from patients undergoing surgical treatment for non-spinal orthopaedic infections, to identify the most appropriate empirical antibiotic strategy. Methods A retrospective review was performed of all cases of non-spinal orthopaedic infections treated surgically from 1 January 2018 to 31 December 2018. The National Health Laboratory Service microbiology database was used to identify all intra-operative microbiological specimens obtained from orthopaedic patients and data was correlated with the orthopaedic surgical database. Cases were divided into fracture related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis. Antibiotic susceptibility data was used to predict the efficacy of different empirical antibiotic regimens. Results A total of 107 cases were included in the study; 184 organisms were cultured. Overall, the most common organism cultured was Staphylococcus aureus (25%) followed by Acinetobacter baumannii (9%), Enterococcus faecalis (7%) and Enterobacter cloacae (5%). Across all categories the oral antibiotic combination with the highest effectiveness (81%) would have been a combination of cotrimoxazole, ciprofloxacin and amoxicillin. The most effective intravenous antibiotic combination would have been either piperacillin-tazobactam, amikacin and vancomycin or meropenem and vancomycin; 90% of tested isolates were susceptible to either of these combinations. Conclusion Antibiogram profiles can serve to guide to empirical antibiotic choice in the management of different categories of non-spinal orthopaedic infections.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/39199 Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit Arakkal, Ashley Laubscher, Maritz Medicine Background Empirical antibiotic strategies in the treatment of fracture related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis should be based on local microbiological antibiograms. Aim To describe the microbiology and review the antibiogram profiles of bacterial isolates from patients undergoing surgical treatment for non-spinal orthopaedic infections, to identify the most appropriate empirical antibiotic strategy. Methods A retrospective review was performed of all cases of non-spinal orthopaedic infections treated surgically from 1 January 2018 to 31 December 2018. The National Health Laboratory Service microbiology database was used to identify all intra-operative microbiological specimens obtained from orthopaedic patients and data was correlated with the orthopaedic surgical database. Cases were divided into fracture related infections, chronic osteomyelitis, prosthetic joint infection, and septic arthritis. Antibiotic susceptibility data was used to predict the efficacy of different empirical antibiotic regimens. Results A total of 107 cases were included in the study; 184 organisms were cultured. Overall, the most common organism cultured was Staphylococcus aureus (25%) followed by Acinetobacter baumannii (9%), Enterococcus faecalis (7%) and Enterobacter cloacae (5%). Across all categories the oral antibiotic combination with the highest effectiveness (81%) would have been a combination of cotrimoxazole, ciprofloxacin and amoxicillin. The most effective intravenous antibiotic combination would have been either piperacillin-tazobactam, amikacin and vancomycin or meropenem and vancomycin; 90% of tested isolates were susceptible to either of these combinations. Conclusion Antibiogram profiles can serve to guide to empirical antibiotic choice in the management of different categories of non-spinal orthopaedic infections. 2024-03-08T06:43:46Z 2024-03-08T06:43:46Z 2023 2024-03-08T06:17:38Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39199 eng application/pdf Division of General Surgery Faculty of Health Sciences
spellingShingle Medicine
Arakkal, Ashley
Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
thesis_degree_str Master's
title Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
title_full Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
title_fullStr Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
title_full_unstemmed Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
title_short Developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a South African tertiary orthopaedic unit
title_sort developing an antibiogram for empiric antibiotic prescribing for orthopaedic infections in adult patients at a south african tertiary orthopaedic unit
topic Medicine
url http://hdl.handle.net/11427/39199
work_keys_str_mv AT arakkalashley developinganantibiogramforempiricantibioticprescribingfororthopaedicinfectionsinadultpatientsatasouthafricantertiaryorthopaedicunit