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JAC Advance Access published online on November 12, 2009
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkp398
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Prosthetic joint infections: single versus combination therapy

J. R. Samuel* and F. K. Gould

Department of Microbiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK

* Corresponding author. Tel: +44-191-223-1248; Fax: +44-191-223-1224; E-mail: julie.samuel{at}nuth.nhs.uk

Prosthetic joint replacement is increasingly used to alleviate pain and increase mobility. Bone and joint infections remain a therapeutic dilemma for healthcare providers in all fields. Antimicrobial agents combined with appropriate surgical techniques play a vital role in eradicating infections associated with prosthetic joints. The question still remains whether monotherapy or combination therapy is effective in this situation because there is a paucity of well-defined comparative studies. We reviewed in vitro and in vivo studies evaluating the effectiveness of various antimicrobial agents either as single agents or in combination.

Key Words: PJIs , synergy , antagonism , antimicrobial combinations , time–kill experiments , bioavailability , pharmacokinetics , biofilms


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