Table 1 Description of the 65 included episodes of BJI and comparison between the intravenous and subcutaneous routes of administration
Total population (n = 65) | Intravenous administration (n = 51) | Subcutaneous administration (n = 14) | p-value | |
|---|---|---|---|---|
Demographics | ||||
Sex (male) | 34 (52.3 %) | 27 (52.9 %) | 7 (50.0 %) | 1.000 |
Age (year-old) | 61.8 (49.0–74.0) | 61.8 (52.1–73.8) | 59.1 (39.1–75.5) | 0.678 |
Comorbidities | ||||
Modified CCI | 3 (1–5) | 3 (2–5) | 1.5 (0.3–5.8) | 0.478 |
BMI (kg/m2) | 27.0 (21.6–29.7) | 27.8 (22.0–31.6) | 24.7 (20.7–28.0) | 0.154 |
Obesity (BMI > 30) | 14 (22.2 %) | 13 (26.5 %) | 1 (7.1 %) | 0.116 |
Diabetes | 8 (12.3 %) | 7 (13.7 %) | 1 (7.1 %) | 0.447 |
Immunosuppression | 11 (16.9 %) | 10 (19.6 %) | 1 (7.1 %) | 0.253 |
Chronic renal failure | 9 (14.8 %) | 6 (12.8 %) | 3 (21.4 %) | 0.338 |
Chronic hepatic disease | 2 (3.3 %) | 2 (4.3 %) | 0 (0 %) | 0.591 |
Chronic pulmonary disease | 15 (24.6 %) | 10 (21.3 %) | 5 (35.7 %) | 0.223 |
Congestive heart failure | 5 (8.1 %) | 3 (6.3 %) | 2 (14.3 %) | 0.314 |
Cerebrovascular disease | 4 (6.6 %) | 1 (2.1 %) | 3 (21.4 %) | 0.035 |
Peripheral artery disease | 5 (8.2 %) | 4 (8.5 %) | 1 (7.1 %) | 0.678 |
Neoplasic disease | 6 (9.8 %) | 6 (12.8 %) | 0 (0 %) | 0.193 |
Malignant hemopathy | 1 (1.5 %) | 1 (2.0 %) | 0 (0 %) | 0.785 |
Inflammatory systemic disease | 9 (14.8 %) | 9 (19.1 %) | 0 (0 %) | 0.079 |
Dementia | 2 (3.1 %) | 2 (3.9 %) | 0 (0 %) | 0.613 |
BJI types | ||||
Native BJI | 20 (30.8 %) | 16 (31.4 %) | 4 (28.6 %) | 0.559 |
Incl. arthritis | 5 (25 %) | 4 (25.0 %) | 1 (25.0 %) | 0.708 |
Incl. osteomyelitis | 5 (25 %) | 5 (31.3 %) | 0 (0 %) | 0.284 |
Incl. vertebral osteomyelitis | 10 (50 %) | 7 (43.8 %) | 3 (75.0 %) | 0.367 |
ODI | 45 (69.2 %) | 35 (68.6 %) | 10 (71.4 %) | 0.559 |
Incl. PJI | 34 (75.6 %) | 28 (80.0 %) | 6 (60.0 %) | 0.187 |
Incl peripheral osteosynthesis | 8 (17.8 %) | 6 (17.1 %) | 2 (20.0 %) | 0.579 |
Incl. vertebral osteosynthesis | 3 (6.7 %) | 1 (2.9 %) | 2 (20.0 %) | 0.119 |
BJI characteristics | ||||
Evolution delay (weeks) | 1.6 (0.1–6.7) | 1.6 (0.4–9.2) | 0.9 (0.2–3.1) | 0.299 |
Chronic BJI (> 3 weeks) | 23 (35.4 %) | 19 (37.3 %) | 4 (28.6 %) | 0.754 |
Mechanism | ||||
Hematogenous | 30 (46.2 %) | 24 (47.1 %) | 6 (42.9 %) | 1.000 |
Inoculation | 32 (49.2 %) | 25 (49.0 %) | 7 (50.0 %) | 1.000 |
Contiguity | 3 (4.6 %) | 2 (3.9 %) | 1 (7.1 %) | 0.523 |
MRSA | 11 (16.9 %) | 9 (17.6 %) | 2 (14.3 %) | 1.000 |
Plurimicrobial infection | 17 (26.2 %) | 16 (31.4 %) | 1 (7.1 %) | 0.062 |
Biological inflammatory syndrom | 61 (95.3 %) | 47 (91.0 %) | 14 (100 %) | 1.000 |
Maximal CRP value (mg/L) | 164 (92–234.3) | 160.2 (86.8–300.0) | 264.7 (143.2–332.0) | 0.245 |
Local and general complications | ||||
Abscess | 26 (40.0 %) | 22 (43.1 %) | 4 (28.6 %) | 0.252 |
Sinus tract | 23 (35.4 %) | 21 (41.2 %) | 2 (14.3 %) | 0.056 |
Infective endocarditis | 2 (3.7 %) | 2 (4.8 %) | 0 (0 %) | 1.000 |
Hospitalization | ||||
Length of stay (weeks) | 5.6 (1.9–8.9) | 5.8 (2.3–8.9) | 3.8 (1.6–8.1) | 0.580 |
Surgical management | 50 (76.9 %) | 38 (74.5 %) | 12 (85.7 %) | 0.491 |
Debridement (native BJI) | 8 (40.0 %) | 5 (31.3 %) | 3 (75.0 %) | 0.153 |
Conservative procedurea | 24 (53.3 %) | 20 (57.1 %) | 4 (40.0 %) | 0.274 |
One-stage exchangea | 3 (6.7 %) | 2 (5.7 %) | 1 (10.0 %) | 0.539 |
Two-stage exchangea | 15 (33.3 %) | 11 (31.4 %) | 4 (40.0 %) | 0.440 |
Antimicrobial therapy | ||||
Total duration (weeks) | 26.8 (17.7–42.8) | 26.2 (17.9–41.6) | 28.4 (17.8–48.4) | 0.406 |
Parenteral treatment | 64 (98.5 %) | 50 (98.0 %) | 14 (100 %) | 1.000 |
Duration (weeks) | 9.4 (5.9–24.4) | 9.4 (6.3–25.1) | 10.4 (4.4–16.1) | 0.790 |
Combination therapy | 65 (100 %) | 51 (100 %) | 14 (100 %) | NC |
Duration (weeks) | 25.7 (16.4–45.1) | 25.6 (15.9–44.3) | 27.6 (21.3–43.2) | 0.442 |
Teicoplanin use | ||||
IV route | 51 (78.5 %) | NA | NA | NA |
Loading dose | 55 (85.9 %) | 44 588.0 %) | 11 (78.6 %) | 0.521 |
Loading dose (mg/kg/12 h) | 5.7 (4.7–6.5) | 5.6 (4.7–6.5) | 6.0 (5.4–6.7) | 0.218 |
Number of injections | 5 (5–5) | 5 (5–5) | 5 (5–5) | |
Maintenance dose (mg/kg/24 h) | 5.7 (4.7–6.5) | 5.6 (4.7–6.5) | 5.9 (5.1–6.8) | 0.406 |
Administration route switch | 7 (10.8 %) | 7 (13.7 %) | 0 (0 %) | 0.164 |
Duration of treatment | ||||
Total duration (weeks) | 6.0 (2.7–9.9) | 6.0 (2.9–9.7) | 5.8 (3.0–11.6 | 0.750 |
IV treatment duration (weeks) | 5.0 (2.9–9.7) | 5.0 (3.0–9.7) | NA | NA |
SC treatment duration (weeks) | 6.2 (3.9–21.4) | NA | 5.3 (2.8–11.6) | NA |
Pharmacological data | ||||
Number of dosages | 2.5 (2–3.3) | 3 (2–3) | 2 (2–3.8) | 0.891 |
Initial Cmin (day 3 to 5, mg/L) | 11.7 (9.2–16.3) | 10.8 (8.6–15.2) | 13.8 (11.4–16.2) | 0.130 |
Initial Cmin >25 mg/L | 0 (0 %) | 0 (0 %) | 0 (0 %) | NC |
Initial Cmin <15 mg/L | 36 (73.5 %) | 29 (74.4 %) | 7 (70.0 %) | 1.000 |
Overdose (day 1 to 14) | 10 (15.6 %) | 8 (16.0 %) | 2 (14.3 %) | 1.000 |
Delay for Cmin > 15 mg/L (days) | 8.5 (6–13) | 9 (6–13) | 7 (4.5–9.5) | 0.259 |
Companion drugs | ||||
Rifampicin | 16 (24.6 %) | 12 (23.5 %) | 4 (28.6 %) | 0.732 |
Fluoroquinolone | 29 (44.6 %) | 20 (39.2 %) | 9 (64.3 %) | 0.131 |
Pristinamycin | 11 (16.9 %) | 11 (21.6 %) | 0 (0 %) | 0.102 |
Teicoplanin-related AE | 6 (10 %) | 4 (8.7 %) | 2 (14.3 %) | 0.617 |
Follow-up and outcome | ||||
Follow-up period (weeks) | 91.1 (50.6–182.6) | 98.0 (58.3–194.9) | 68.2 (40.7–100.3) | 0.112 |
One-month CRP level < 10 mg/L | 17 (27.9 %) | 14 (28.0 %) | 3 (27.3 %) | 1.000 |
Treatment failure | 27 (41.5 %) | 21 (41.2 %) | 6 (42.9 %) | 1.000 |
Persisting infection | 18 (28.6 %) | 14 (28.0 %) | 4 (30.8 %) | 1.000 |
Relapse | 6 (9.7 %) | 6 (12.2 %) | 0 (0 %) | 0.328 |
Iterative surgery | 23 (35.9 %) | 19 (38.0 %) | 4 (28.6 %) | 0.754 |
BJI-related death | 1 (1.6 %) | 1 (2.0 %) | 0 (0 %) | 1.000 |
Superinfection | 13 (20.0 %) | 10 (19.6 %) | 3 (21.4 %) | 1.000 |