2026-04-13T14:25:05Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/135702025-10-24T10:27:22Zcom_2072_378070com_2072_378040col_2072_378092

To heal or harm: A systematic review of the role of fluoroquinolones in periprosthetic joint infections Tevell, Staffan Aboltins, Craig Hewlett, Angela Young, Bernadette Rodríguez Pardo, Ma Dolores Articulacions artificials Malalties bacterianes - Tractament Estafilococs Medicaments antibacterians - Ús terapèutic - Efectes secundaris ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Prostheses and Implants::Joint Prosthesis Other subheadings::Other subheadings::Other subheadings::/adverse effects DISEASES::Bacterial Infections and Mycoses::Infection::Prosthesis-Related Infections ORGANISMS::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus CHEMICALS AND DRUGS::Heterocyclic Compounds::Heterocyclic Compounds, Fused-Ring::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones::Fluoroquinolones Other subheadings::Other subheadings::Other subheadings::/adverse effects TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::prótesis e implantes::prótesis articulares Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones relacionadas con prótesis ORGANISMOS::Bacteria::bacterias formadoras de endosporas::bacterias grampositivas formadoras de endosporas::bacilos grampositivos formadores de endosporas::Staphylococcaceae::Staphylococcus COMPUESTOS QUÍMICOS Y DROGAS::compuestos heterocíclicos::compuestos heterocíclicos con anillos de fusión::compuestos heterocíclicos de 2 anillos::quinolinas::quinolonas::fluoroquinolonas Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos Fluoroquinolones; Periprosthetic joint infections; Efficacy Fluoroquinolones; Infeccions articulars periprotètiques; Eficàcia Fluoroquinolonas; Infecciones articulares periprotésicas; Eficacia Background Fluoroquinolones (FQs) are currently recommended for the treatment of periprosthetic joint infections (PJIs) caused by staphylococci and Gram-negative bacteria (GNB) in patients undergoing debridement, antibiotics and implant retention (DAIR). In recent decades, reports of serious adverse events associated with FQ use have led to official regulatory recommendations for their restricted use. This review aims to describe the evidence for, and discuss the risks and benefits of, FQ use for PJI. Methods A comprehensive search of MEDLINE and EMBASE up to October 2024 was conducted using pre-defined criteria to identify studies addressing (i) the efficacy of FQs in treating staphylococcal and GNB-PJI, and (ii) serious adverse events associated with FQs. A narrative synthesis of the results was performed. Results No randomized controlled trials were identified. A total of 19 retrospective studies were reviewed to assess the efficacy of FQs in treating staphylococcal and GNB-PJI, though the sample sizes in these studies were relatively small. Fifty-seven studies, mostly large retrospective epidemiological cohorts, were found evaluating adverse events associated with FQ treatment. Conclusions There is evidence supporting the use of FQ monotherapy for GNB-PJI and FQ combined with rifampin for staphylococcal PJIs following DAIR over other antimicrobial regimens. There is evidence that FQs are associated with an increased risk of tendinopathy, prolonged QTc interval, peripheral neuropathy and dysglycaemia, however the absolute risk is low. When FQs are used in the treatment of PJIs, an individualized risk assessment and close monitoring during treatment are recommended. S.T. is supported by the Research committee of Region Värmland (LIVFOU) and by grants from the Swedish state under the ALF agreement between the Swedish government and the county councils (Region Örebro County, Sweden OLL-967677). B.Y. is supported by the National institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). 2025-10-24T10:27:22Z 2025-10-24T10:27:22Z 2025-10-24T10:27:22Z 2025-08-25T07:17:11Z 2025-08-25T07:17:11Z 2025-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13570 CMI Communications;2(3) https://doi.org/10.1016/j.cmicom.2025.105103 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia