Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 476-483
DOI: https://doi.org/10.52403/ijrr.20261043
Bacterial Profiles and Empiric Antibiotic Therapy in Prosthetic Joint Infection: A Systematic Literature Review
Thomas Erwin Christian Junus Huwae1, Agung Riyanto Budi Santoso1, Krisna Yuarno Phatama1, Ananto Satya Pradana1, Addam Irsyaddyra1, Hudzaifah Al Azmi Manaf1
1Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya – Dr. Saiful Anwar General Hospital, Malang, Indonesia
Corresponding Author: Thomas Erwin Christian Junus Huwae
ABSTRACT
Introduction: Prosthetic joint infection (PJI) is a serious complication of joint arthroplasty that requires appropriate antimicrobial therapy. This systematic literature review aimed to identify the predominant bacterial pathogens associated with PJI and summarize empiric antibiotic regimens used in its management.
Methods: A literature search was conducted using Google Scholar for studies published between 2019 and 2023. Studies involving patients with PJI, microbiological culture findings, and empiric antibiotic therapy were included. Data were synthesized descriptively.
Results: Five retrospective studies involving 555 patients met the eligibility criteria. Staphylococcus aureus was the most consistently reported causative pathogen, followed by coagulase-negative staphylococci and several Gram-negative organisms. Empiric regimens varied considerably and included vancomycin, fluoroquinolones, cefazolin, flucloxacillin, amoxicillin/clavulanate, and combination therapies. Vancomycin-based combinations with imipenem or ciprofloxacin provided broad antimicrobial coverage in several studies. However, the optimal regimen differed according to bacterial distribution, resistance patterns, and clinical setting.
Conclusion: Staphylococcus aureus was the predominant pathogen identified in PJI. Empiric antibiotic therapy should provide appropriate staphylococcal coverage while considering additional Gram-negative coverage when indicated. Treatment should be guided by local antimicrobial susceptibility patterns and subsequently adjusted according to culture and sensitivity results.
Keywords: antibacterial agents; prosthesis-related infections; Staphylococcus aureus; vancomycin.
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