https://opat-conference.com/

https://bsac.org.uk/

Evaluating the Safety and Tolerability of Oral Antibiotic Regimens in Orthopaedic Infections: Lessons Learned and Current Perspectives

| Presenters | Antonia Scobie & Tariq Azamgarhi, Royal National Orthopaedic Hospital | | --- | --- |

https://www.nejm.org/doi/full/10.1056/NEJMoa1710926

• Rifampicin-based regimen preferred for S. aureus - ideally fluoroquinolone (FQ)

Mostly:

• Oral prescribing done by GPs.

  • Standardised letter used to delineate roles/responsibilities

• 75% IVOS rate

• Similar real-world outcomes at 1y; no difference in survival

  • Cost reduction: £2.8k
  • Reduced LoS: 4d
  • Fewer line complications

• Oral ADR rate: 37%

• Tolerability:

  

• FQ MHRA Alert:

  • All observational data, but reasonable link to collagen-based ADRs.

  • But is this high risk?

    Drug	ADR	NNH
    Quinolone	Aortic Dissection	11,111
    Aspirin	UGIB	275-1429
    Teicoplanin	Anaphylaxis	1786-2273

Revisiting oral antibiotic options for the treatment of ABSSSI