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JAC Advance Access published online on November 3, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki382
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© The Author 2005. 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

Leading article

Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus

S. F. FitzGerald 1*, C. Kelly 2, and H. Humphreys 1

1 Department of Microbiology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin, Ireland
2 Department of Surgery, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin, Ireland

* To whom correspondence should be addressed.
S. F. FitzGerald, E-mail: suzyfitz{at}eircom.net


  Abstract

Prosthetic aortic graft infections represent a major diagnostic and therapeutic challenge. Although a combination of clinical assessment, imaging and microbiological investigations is usually helpful, there are no agreed criteria to confirm a diagnosis. Potential pathogens isolated from superficial specimens may be misleading but influence the choice of antimicrobial agents. Removal of the infected material is strongly recommended. However, this is not always possible in the very debilitated or clinically unstable patient. The choice of which antimicrobial agents to administer as empirical or definitive therapy and the duration of treatment are unclear. A multi-disciplinary group is required to offer guidance, based on what evidence there is, and to provide expert consensus (as is the case for infective endocarditis) to optimize the management of these difficult infections.

Keywords: vascular grafts; antibiotics; management.
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