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This review article examines the evolving role of oral antibiotics in treating shoulder periprosthetic joint infection (PJI), contrasting it with the conventional approach of prolonged IV antibiotics via PICC lines. It highlights the OVIVA trial's findings on oral antibiotics for complex orthopedic infections and discusses the limited but growing body of evidence, primarily from small, retrospective studies, regarding their use in shoulder PJI. The review emphasizes the need for high-quality, multicenter trials to confirm the efficacy of oral antibiotic therapy in select cases of shoulder PJI.
Oral antibiotics may offer a viable alternative to prolonged IV antibiotics for select shoulder PJI cases, potentially reducing complications and costs associated with PICC lines and extended hospitalizations.
Abstract » Conventional treatment of shoulder periprosthetic joint infection (PJI) consists of prolonged intravenous (IV) antibiotics injected into a PICC line. This method can be associated with adverse events such as catheter-related infections, extended hospitalizations, and higher medical costs. » The OVIVA trial demonstrated that oral antibiotics are no less effective than IV antibiotics as previously thought for complex orthopedic infections. These findings have sparked interest in the use of oral antibiotics for shoulder PJI. » Current data on the use of oral antibiotics in shoulder PJI is limited but growing. A number of studies assess the effects of oral antibiotic therapy on the shoulder, with most being small and retrospective. » Early evidence in shoulder PJI suggests that oral antibiotic therapy may provide satisfactory outcomes in select cases, though confirmation in high-quality, multicenter trials is essential.
