What is the role of surgery in the treatment of implant-associated Cutibacterium (Propionibacterium) infections?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  more...
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Answer

Owing to the variable clinical presentation of C acnes implant-associated infections, there is no general consensus on best treatment. Surgical recommendations, however, should not differ dramatically from infections caused by other microorganisms. Implant-associated infections require surgical removal of the infected implant and debridement of any infected tissue and dead bone. As C acnes infection typically has a delayed presentation following implant surgery, extensive and aggressive debridement of all infected tissue with removal of the implant is recommended. Surgical therapy needs to be accompanied by prolonged antibiotic treatment in order to ensure eradication of remaining bacteria. For most prosthetic joint infections, a 3- to 6-month course of antibiotic treatment is suggested, including 2-6 weeks of intravenous treatment with a beta-lactam, depending on implant size. [6]


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