Early switch to oral antibiotics (<2 weeks) versus standard intravenous regimens (≥2 weeks) in prosthetic joint infection - A retrospective study using Dutch Arthroplasty Register (LROI) data.
Approval date: April 17th 2026
ES Veltman, FCA Koelewijn, M Reijman, JHM Goosen, OP van der Jagt, DJF Moojen, PK Bos, DE Meuffels
Research proposal abstract:
Prosthetic Joint Infection (PJI) is a devastating complication in total hip and knee arthroplasty, affecting approximately 1-2% of the cases. Traditional antibiotic treatment regimens consists of (at least) two weeks intravenous (IV) antibiotics, followed by oral agents up to 12 weeks in total. However, our 2024 nationwide survey study in the Netherlands, showed that about 50% of the institutions who regularly treat PJI (n = 22) employ shorter durations of IV antibiotics and switch to oral agents sooner.[1] To date there is a scarcity in comparative studies evaluating standard IV (≥2 weeks) versus short IV treatment (<2 weeks) for PJI specifically.
Shorter IV periods may lead to shorter hospital stays, reduced costs, fewer side effects, and therefore potentially greater patient satisfaction. Yet, evidence regarding its efficacy and safety in achieving adequate infection eradication is lacking.
In this study, we will use LROI data to evaluate whether a protocolised intended early switch to oral antibiotics (<2 weeks) is comparable to standard IV duration (≥2 weeks) regarding risk of re-revision due to infection. Goal of this study is to generate a hypothesis whether an early switch to oral antibiotic therapy in PJI treatment is safe, which can be used for further clinical studies.