10.6 Orthopaedic implant associated infections
- Blood/Pus culture should be obtained before starting antimicrobial therapy
- Empirical treatment should be started with acute osteomyelitis guidelines
Definitive antibiotic therapy should be started as soon as culture results are available
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Orthopedic implant associated infections | Debridement Empirical treatment as per acute osteomyelitis guidelines Targeted antibiotic as per culture report | As in acute osteomyelitis Definitive antibiotic therapy should be started as soon as culture results are available | Implant-related infections are the result of bacteria adhesion or subsequent biofilm formation. Implant removal or debridement as per the clinical decision. In case there is pus discharge/implant visible do not start empirical antibiotics, preferably wait for deep culture report. |
For common etiological agents of Orthopaedic implant associated infections, see Annexure B.10.6
References
1. Li X, Sun L, Zhang P, Wang Y. Novel Approaches to Combat Medical Device-Associated BioFilms. Coatings. 2021; 11(3):294. Page 1-31. Available from: https://doi.org/10.3390/coatings11030294
2. Ihtisham Ul Haq, Taj Ali Khan, Katarzyna Krukiewicz, Etiology, pathology, and host-impaired immunity in medical implant-associated infections, Journal of Infection and Public Health, Volume 17, Issue 2, 2024, Pages 189-203, ISSN 1876-0341, https://doi.org/10.1016/j.jiph.2023.11.024
3. Kennedy DG, O'Mahony AM, Culligan EP, O'Driscoll CM, Ryan KB. Strategies to Mitigate and Treat Orthopaedic Device-Associated Infections. Antibiotics (Basel). 2022 Dec 15;11(12):1822. doi: 10.3390/antibiotics11121822. PMID: 36551479; PMCID: PMC9774155.
4. Treatment Guidelines for Antimicrobial Use in Common Syndromes. 2nd edition. ICMR. 2019. New Delhi (Accessed on 2nd April, 2025). Available from: https://www.icmr.gov.in/icmrobject/custom_data/pdf/resource-guidelines/Treatment_Guidelines_2019_Final.pdf