A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study)

METRC

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1 Citation (Scopus)

Abstract

Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious. The POvIV study is a prospective, multicenter, randomized trial to compare PO with IV antibiotic therapy in patients with postoperative wound infections after extremity fractures. Patients between the ages of 18 and 84 who have a culture-positive surgical site infection after internal fixation for fracture repair or arthrodesis are approached for this study, and if they provide consent, are randomly assigned to receive either PO or IV antibiotics. Antibiotic selection is based on culture and sensitivity results. Randomization determines the route of administration. Patients are followed for 1 year after study enrollment. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.

Original languageEnglish (US)
Pages (from-to)S32-S38
JournalJournal of orthopaedic trauma
Volume31
DOIs
StatePublished - Jan 1 2017

Fingerprint

Surgical Wound Infection
Extremities
Anti-Bacterial Agents
Therapeutics
Internal Fracture Fixation
Arthrodesis
Standard of Care
Random Allocation
Infection
Venous Thrombosis
Biological Availability
Multicenter Studies
Sepsis
Safety
Costs and Cost Analysis

Keywords

  • Antibiotics
  • Extremity fractures
  • Fixation
  • IV
  • Joint fusions
  • PO
  • Surgical site infection
  • Wound infection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{b88ac3adb3154ac78b76855a7a70e759,
title = "A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study)",
abstract = "Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious. The POvIV study is a prospective, multicenter, randomized trial to compare PO with IV antibiotic therapy in patients with postoperative wound infections after extremity fractures. Patients between the ages of 18 and 84 who have a culture-positive surgical site infection after internal fixation for fracture repair or arthrodesis are approached for this study, and if they provide consent, are randomly assigned to receive either PO or IV antibiotics. Antibiotic selection is based on culture and sensitivity results. Randomization determines the route of administration. Patients are followed for 1 year after study enrollment. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.",
keywords = "Antibiotics, Extremity fractures, Fixation, IV, Joint fusions, PO, Surgical site infection, Wound infection",
author = "METRC and Obremskey, {William T.} and Schmidt, {Andrew H.} and O'Toole, {Robert V.} and Jennifer DeSanto and Saam Morshed and Paul Tornetta and Murray, {Clinton K.} and Jones, {Clifford B.} and Scharfstein, {Daniel O.} and Taylor, {Tara J.} and Carlini, {Anthony R.} and Castillo, {Renan C.} and H. Silva and H. Carlisle and Bosse, {M. J.} and Hsu, {J. R.} and Seymour, {R. B.} and C. Churchill and Karunakar, {M. A.} and Passaretti, {C. L.} and Sims, {S. H.} and Weinrib, {D. A.} and Horton, {J. M.} and Hak, {D. J.} and Henderson, {C. E.} and C. Mauffrey and W. Miller and Stahel, {P. F.} and H. Young and Mullis, {B. H.} and Anglen, {J. O.} and Ertl, {J. P.} and Shively, {K. D.} and Mirick, {G. E.} and Westberg, {J. R.} and Hymes, {R. A.} and L. Ramsey and S. Haaser and Vallier, {H. A.} and Breslin, {M. A.} and Smith, {C. S.} and Crickard, {C. V.} and Konda, {S. R.} and Reid, {J. S.} and Horne, {A. H.} and Stinner, {D. J.} and Cannada, {L. K.} and Stephen Quinnan and {Hutson, Jr.}, James and Zych, {Gregory A}",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/BOT.0000000000000802",
language = "English (US)",
volume = "31",
pages = "S32--S38",
journal = "Journal of Orthopaedic Trauma",
issn = "0890-5339",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study)

AU - METRC

AU - Obremskey, William T.

AU - Schmidt, Andrew H.

AU - O'Toole, Robert V.

AU - DeSanto, Jennifer

AU - Morshed, Saam

AU - Tornetta, Paul

AU - Murray, Clinton K.

AU - Jones, Clifford B.

AU - Scharfstein, Daniel O.

AU - Taylor, Tara J.

AU - Carlini, Anthony R.

AU - Castillo, Renan C.

AU - Silva, H.

AU - Carlisle, H.

AU - Bosse, M. J.

AU - Hsu, J. R.

AU - Seymour, R. B.

AU - Churchill, C.

AU - Karunakar, M. A.

AU - Passaretti, C. L.

AU - Sims, S. H.

AU - Weinrib, D. A.

AU - Horton, J. M.

AU - Hak, D. J.

AU - Henderson, C. E.

AU - Mauffrey, C.

AU - Miller, W.

AU - Stahel, P. F.

AU - Young, H.

AU - Mullis, B. H.

AU - Anglen, J. O.

AU - Ertl, J. P.

AU - Shively, K. D.

AU - Mirick, G. E.

AU - Westberg, J. R.

AU - Hymes, R. A.

AU - Ramsey, L.

AU - Haaser, S.

AU - Vallier, H. A.

AU - Breslin, M. A.

AU - Smith, C. S.

AU - Crickard, C. V.

AU - Konda, S. R.

AU - Reid, J. S.

AU - Horne, A. H.

AU - Stinner, D. J.

AU - Cannada, L. K.

AU - Quinnan, Stephen

AU - Hutson, Jr., James

AU - Zych, Gregory A

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious. The POvIV study is a prospective, multicenter, randomized trial to compare PO with IV antibiotic therapy in patients with postoperative wound infections after extremity fractures. Patients between the ages of 18 and 84 who have a culture-positive surgical site infection after internal fixation for fracture repair or arthrodesis are approached for this study, and if they provide consent, are randomly assigned to receive either PO or IV antibiotics. Antibiotic selection is based on culture and sensitivity results. Randomization determines the route of administration. Patients are followed for 1 year after study enrollment. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.

AB - Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious. The POvIV study is a prospective, multicenter, randomized trial to compare PO with IV antibiotic therapy in patients with postoperative wound infections after extremity fractures. Patients between the ages of 18 and 84 who have a culture-positive surgical site infection after internal fixation for fracture repair or arthrodesis are approached for this study, and if they provide consent, are randomly assigned to receive either PO or IV antibiotics. Antibiotic selection is based on culture and sensitivity results. Randomization determines the route of administration. Patients are followed for 1 year after study enrollment. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.

KW - Antibiotics

KW - Extremity fractures

KW - Fixation

KW - IV

KW - Joint fusions

KW - PO

KW - Surgical site infection

KW - Wound infection

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U2 - 10.1097/BOT.0000000000000802

DO - 10.1097/BOT.0000000000000802

M3 - Article

C2 - 28323799

AN - SCOPUS:85017292838

VL - 31

SP - S32-S38

JO - Journal of Orthopaedic Trauma

JF - Journal of Orthopaedic Trauma

SN - 0890-5339

ER -