Hsieh et al listed criteria for treatment failure of a prosthetic joint infection (PJI). The authors are from Chang Gung Memorial Hospital in Taoyuan, Taiwan.
Patient selection: A patient with a history of prosthetic joint infection at any time after completion of a therapeutic regimen.
Criteria for treatment failure:
(1) relapse of infection (infection caused by the same strain)
(2) reinfection (infection caused by a different strain or species of bacteria)
(3) presence of gross purulence around the prosthetic joint seen at surgery
(4) histologic evidence of infection in a biopsy of periprosthetic tissue
(5) development of a sinus tract
(6) sepsis or death related to the joint infection
where:
• Reinfection may not represent a complete failure of therapy since the original infection was eliminated. From the patient's perspective there still is a joint infection.
• A relapse caused by a failure to completely clear the infection usually becomes evident soon after antibiotics are discontinued.
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