Short-Term Outcomes of Phage-Antibiotic Combination Treatment in Adult Patients with Periprosthetic Hip Joint Infection
Eugeny Fedorov,
Alexander Samokhin,
Yulia Kozlova,
Svetlana Kretien,
Taalai Sheraliev,
Vera Morozova,
Nina Tikunova,
Alexey Kiselev,
Vitaliy Pavlov
Affiliations
Eugeny Fedorov
Orthopedics Department, Novosibirsk Research Institute of Traumatology and Orthopedics, 630091 Novosibirsk, Russia
Alexander Samokhin
Biotechnology Department, Novosibirsk State Technical University, 630073 Novosibirsk, Russia
Yulia Kozlova
Laboratory of Molecular Microbiology, Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
Svetlana Kretien
Orthopedics Department, Novosibirsk Research Institute of Traumatology and Orthopedics, 630091 Novosibirsk, Russia
Taalai Sheraliev
Orthopedics Department, Novosibirsk Research Institute of Traumatology and Orthopedics, 630091 Novosibirsk, Russia
Vera Morozova
Laboratory of Molecular Microbiology, Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
Nina Tikunova
Laboratory of Molecular Microbiology, Institute of Chemical Biology and Fundamental Medicine of the Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
Alexey Kiselev
Biostatistics Department, Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry of Health of the Russian Federation, 192019 Saint-Petersburg, Russia
Vitaliy Pavlov
Orthopedics Department, Novosibirsk Research Institute of Traumatology and Orthopedics, 630091 Novosibirsk, Russia
Implant-associated infections are the most costly problem in modern orthopedics due to the continued increase in the occurrence of antibiotic-resistant bacterial strains that requires the development of new effective antimicrobials. A non-randomized, prospective, open-label, with historical control study on the use of combined phage/antibiotic therapy of periprosthetic joint infection (PJI) was carried out. Forty-five adult patients with deep PJI of the hip joint were involved in the study, with a 12-month follow-up after one-stage revision surgery. Patients from a prospective study group (SG, n = 23) were treated with specific phage preparation and etiotropic antibiotics, whereas patients from a retrospective comparator group (CG, n = 22) received antibiotics only. The rate of PJI relapses in the SG was eight times less than that in the CG: one case (4.5%) versus eight cases (36.4%), p = 0.021. The response rate to treatment was 95.5% (95% confidence interval (CI) = 0.7511–0.9976) in the SG and only 63.6% (95% CI = 0.4083–0.8198) in the CG. The odds ratio for PJI relapse in patients of the SG was 0.083 (95% CI = 0.009–0.742), which was almost 12 times lower than that in the CG. The obtained results support the efficacy of the combined phage-antibiotic treatment of PJI.
