A prosthetic joint infection (PJI) is a severe complication after arthroplasty. From the current thesis, three main conclusion can be drawn regarding diagnosis and treamtent of PJI. (a) Accurate... Show moreA prosthetic joint infection (PJI) is a severe complication after arthroplasty. From the current thesis, three main conclusion can be drawn regarding diagnosis and treamtent of PJI. (a) Accurate self-monitoring of postoperative wounds after joint implantation helped elucidate the course of wound leakage and its association with acute prosthetic joint infections. (b) The collection of clinical data on different antimicrobial treatment strategies provided insight into the effectiveness of different treatment options for patients with a prosthetic joint infection. In this thesis, we report that personalized antimicrobial treatment for prosthetic joint infections is possible without compromising the effectiveness of treatment. (c) this thesis describes the role and importance of new anti-persister drugs against biofilm-associated infections. We developed a biofilm model that closely resembles the clinic of a prosthetic joint infection. Based on the results described in this thesis, future research will be aimed at better understanding the pathogenesis of biofilms. This should ultimately lead to better treatment options for patients with a prosthetic joint infection. Show less
Introduction: A periprosthetic joint infection (PJI) is a major complication of arthroplasty. Treatment of PJI consists of surgical debridement with or without the exchange of the implant and long... Show moreIntroduction: A periprosthetic joint infection (PJI) is a major complication of arthroplasty. Treatment of PJI consists of surgical debridement with or without the exchange of the implant and long-term antimicrobial treatment. Rifampicin is regarded as one of the cornerstones of antimicrobial treatment for staphylococcal PJI, but the exact role of rifampicin for PJI in different clinical scenarios remains to be elucidated.Areas covered: In this perspective article, an overview is provided of in vitro, in vivo and clinical studies that were the basis of the current guidelines and recommendations for rifampicin use in daily practice for PJI. Controversial issues on indication, dosing, timing, duration, and antibiotic drug interactions will be addressed. Finally, the most urgent clinical questions on rifampicin use that need answering in the nearby future will be formulated.Expert Opinion: Many inquiries remain concerning the exact indications and clinical use of rifampicin in PJI. Randomized controlled trials are needed to answer these questions. Show less