Antibiotics in Treatment of Periprosthetic Joint Infections

The infection rate after joint arthroplasty is about 1–3 % in spite of correct surgical techniques, aseptic measures, and antibiotic prophylaxis (Clin Infect Dis 46:1009–1014, 2008). Taking into account the increasing number of arthroplasties performed each year in the developed world; a parallel increase in the number of prosthetic joint infections is expected. The management of these infections is complex due to the progressive increase in antibiotic resistant bacteria and the ability of bacteria to grow forming biofilms on the implant surface. The aim of the present chapter is to provide a general knowledge about antibacterial agents and the main characteristics of available antimicrobial families for treating the most frequent pathogens producing prosthetic joint infections. The description of each group of antibiotics includes the following aspects: mechanism of action, antibacterial spectrum, pharmacodynamic index predicting the efficacy, concentration achieved in bone, recommended dosages and way of administration, and the most relevant adverse events.