Bilateral One-Stage Revision of Infected Total Hip Arthroplasties: Report of Two Cases and Management of Antibiotic Therapy

Table 1

Demographic, microbiological, and therapeutic data.

	Case  1		Case  2
	Left hip	Right hip	Left hip	Right hip
Date of index surgery	2009	2010	2006	2009
Indication for THA	Primary osteoarthritis
ASA score	2		2
CRP level at diagnosis ( mg/L)	18 mg/L		81 mg/L
White blood cells count (–10000/mm^3)	11700/mm^3		12500/mm^3
Neutrophil polynuclear cells count (–8000/mm^3)	9360/mm^3		9850/mm^3
Date of joint aspiration	02/11/2011	02/11/2011	02/07/2012	14/07/2012
Bacteria at culture	⁢Staphylococcus caprae sensitive to ⁢methicillin (coagulase negative)		⁢Methicillin-sensitive; Staphylococcus aureus (MSSA)
Date of 1-stage bilateral revision	21/11/2011		06/08/2012
Delay from probabilistic ATB to sample collection in the second hip	180 minutes		180 minutes
Probabilistic ATB	Cefepime + daptomycin		Cefotaxime + vancomycin
Culture-guided ATB debuted intravenously on day 5 for 5 days and then switched to oral for 10 weeks	Rifampicin + levofloxacin		Rifampicin + levofloxacin
Positivity of culture samples on the second side	⁢Same bacteria; 4 out of 6 samples; (3 Rosenow’s broth and 1 standard)		⁢Same bacteria; 4 out of 6 samples; (2 Rosenow’s broth and 2 standard)
CRP at the time of withdrawal of antibiotic therapy ( mg/L)	5 mg/L		3 mg/L
Intraoperative bleeding	1200 cc		1600 cc
Posttreatment follow-up duration	36 months		24 months

ATB: antibiotics therapy; CRP: C-reactive protein.