Prolonged suppression of XXXX .

@entity1 @entity281 @entity295 @entity572
Nineteen @entity281 after total hip arthroplasty were treated with prolonged suppressive antibiotics without removing the components. In 11, antibiotic therapy was monitored with serum bactericidal titers. Eleven had incision and drainage. Indications included @entity1 ' refusal of removal or medical contraindications to surgery. Requirements included well-fixed components, highly sensitive organisms, and no systemic @entity295 . The follow-up period averaged 4.1 years after treatment. Nine hips showed no deterioration. Seven prostheses failed, five with progressive @entity572 . Three @entity1 had increasing symptoms without prosthesis removal. Although two-stage reimplantation is preferred, suppressive antibiotics and prosthesis retention can succeed in some @entity1 and may be considered in old, frail @entity1 with an @entity281 caused by bacteria responsive to oral antibiotic therapy. Suppressive therapy may also be considered for an otherwise compliant @entity1 who refuses removal of an infected prosthesis. The organism must be sensitive to oral antibiotics, and the @entity1 must be tolerant of the antibiotics.
