A new IDSA practice guideline for the diagnosis and management of prosthetic joint infection (PJI) is available online and appeared in the Jan. 1 issue of Clinical Infectious Diseases.

The guideline is intended for infectious disease specialists, orthopedists, and internists who care for patients with PJI. An essential component of this care is a strong collaboration between medical and surgical specialists (e.g., orthopedic surgeons and ID specialists). Consequently, the guideline identifies the preferred method of diagnosis for patients with PJI, such as preoperative evaluation and intraoperative testing, and addresses the necessity for surgical intervention and prolonged courses of intravenous or oral antimicrobial therapy.

Several recommendations for appropriate treatment of debridement, retention of prosthesis, and resection arthroplasty are provided. In addition, recommendations for preferred treatment regimens (e.g., dosage of rifampin following debridement) and information leading to the reduction of morbidity, mortality, and costs associated with PJI are also included. “The guideline authors hope these recommendations will benefit patient care and provide a valuable resource for clinicians caring for patients with prosthetic joint infection,” said lead author Douglas R. Osmon, MD, associate professor of medicine in the division of infectious diseases at the Mayo Clinic in Rochester, Minn.

The guideline acknowledges that not all medical institutions will have the necessary resources to implement all of the outlined recommendations and that proper referrals to specialty centers may be needed. Also, several research gaps are identified, such as in the epidemiology, management, and prevention of PJI.

The guideline is available as a pocket-sized quick-reference edition. Visit the practice guidelines section of the IDSA website for additional guidelines and related resources, including a new Guidelines Discussion Forum, which allows members and others to comment on recently published IDSA practice guidelines.

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