DATIPO

Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection.

Bernard L, Arvieux C, Brunschweiler B, et al. The New England journal of medicine 2021 · PMID 34042388 · doi:10.1056/nejmoa2020198

Question

Is 6 weeks of antibiotics non-inferior to 12 weeks after surgical management of prosthetic joint infection?

Design

Open-label, multicentre non-inferiority RCT in French hospitals.

Patients

Adults with microbiologically confirmed PJI treated surgically by DAIR, one-stage or two-stage exchange.

Intervention

6 weeks of antibiotic therapy

Comparison

12 weeks of antibiotic therapy

Primary outcome

Persistent infection within 2 years after completion of antibiotics

Key result

Non-inferiority of 6 weeks was not shown: persistent infection was more frequent with 6 weeks than 12 weeks, with the difference most marked in patients treated by DAIR.

Limitations

Open-label with mixed surgical strategies; the trial was not powered for surgical subgroups, and antibiotic choices varied.

Impact on practice

Supports 12 weeks of antibiotics after DAIR for PJI rather than shortening to 6 weeks; less clear for staged exchange.