{
  "abstract": "Background and Importance Implant-associated osteoarticular infections (IAOIs) remain one of the most serious complications in orthopaedic and trauma surgery. They result from complex host–pathogen interactions and may lead to prolonged disability, revision surgery, and high treatment costs. The 2018 Association for Osteosynthesis consensus defines these infections as those involving prosthetic implants or osteosynthesis devices. Their prevention and management require accurate microbiological diagnosis and rational antibiotic use, both crucial to patient safety and infection control standards.Aim and Objectives This audit aimed to assess the incidence of IAOIs, describe the microbial spectrum, and evaluate antibiotic prescribing patterns to identify areas for optimisation of antimicrobial stewardship and interprofessional coordination.Material and Methods A retrospective descriptive study was performed from January to December 2023. Data were retrieved from antibiotic prescription charts and the STKMED software for all patients with documented implant-related infections. Demographic variables, implant type, isolated pathogens, and antibiotic regimens were recorded. Data were analysed using Microsoft Excel, and antibiotic choices were compared with evidence-based guidelines. Antibiotics were classified according to the WHO Anatomical Therapeutic Chemical (ATC) system.Results Thirty-four patients met the inclusion criteria, corresponding to an infection incidence of 1.17%. Median age was 56 years (sex ratio 0.8). Prosthesis-related infections accounted for 35%, and osteosynthesis-device infections for 65%. Gram-positive cocci predominated (76.5%), with Staphylococcus aureus isolated in 50.6% of all cultures; Gram-negative bacilli represented 14.7%, mainly Pseudomonas aeruginosa and Enterobacter cloacae. Antibiotic therapy was documented in 57% of cases. The most frequent combinations were fluoroquinolone + rifamycin (67.6%), glycopeptide + rifamycin (20.6%), and glycopeptide + fosfomycin (11.8%). Although quinolone–rifamycin regimens were consistent with guidelines for staphylococcal infections, sub-optimal documentation and lack of multidisciplinary validation limited overall therapeutic optimisation.Conclusion and Relevance IAOIs require integrated management between surgeons, infectious disease specialists and pharmacists. The predominance of S. aureus highlights the need for systematic bacteriological testing and guideline-based antibiotic review. Strengthening antibiotic documentation, implementing stewardship dashboards, and fostering interprofessional review meetings would enhance safety, reduce recurrence, and align practice with international standards.References and/or Acknowledgements 1. Metsemakers W-J, et al. Infection after fracture fixation: current surgical and microbiological concepts. Injury. 2018;49(3):511–522.2. Zimmerli W, Trampuz A. Prosthetic-joint-associated infections. N Engl J Med. 2004;351(16):1645–1654.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Pharmacy Department, Centre for Traumatology and Major Burns, Tunisia, Ben Arous, Ben Arous, Tunisia"
      ],
      "name": "W Guibane"
    }
  ],
  "title": "5PSQ-154 Antibiotic strategies and microbiological patterns in implant-associated osteoarticular infections: insights from a trauma surgery audit",
  "uid": "ac5b8c22-49d3-5c29-b5e8-bd85b3325af1"
}