Serious orthopedic infections require prolonged treatment of intravenous antibiotic therapy. However, recent evidence suggests that oral treatment might as well be effective in bone and joint infections. This study aims to investigate whether oral antibiotic therapy is non-inferior to intravenous antibiotic therapy for orthopedic infections.

This study included a total of 1,015 participants who were undergoing treatment for bone or joint infection. Within seven days after the surgery or the start of antibiotic treatment, the participants were randomly assigned to receive either intravenous (n=506) or oral (n=509) antibiotics for the first six weeks of therapy. The primary outcome of the study was definitive treatment failure within one year after the completion of the therapy.

Treatment failure was reported in 74 of 506 patients (14.6%) in the intravenous group and 67 of 507 (13.2%) in the oral group. The insignificant difference between the risk of definitive treatment failure in two groups indicated non-inferiority. Serious adverse events occurred in 146 (27.7%) and 138 (26.2%), respectively. However, catheter complications were more common in the intravenous group.

The research concluded that oral antibiotic therapy was non-inferior to intravenous antibiotic therapy during the first six weeks of treatment for bone or joint infections.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1710926