Date: 31 January 2019
Pills are just as effective as intravenous (IV) injections in tackling bone infections, a study published in The New England Journal of Medicine has found, raising hopes that patients could go home sooner and reduce NHS costs.
The findings challenge the long held belief that injections into the vein are the best way to give antibiotics for bone and joint infections such as infected hip or knee replacements.
The study recruited more than 1,000 people with bone or joint infection and randomly allocated them to injection or tablet antibiotics. In most cases, patients underwent surgery as well.
Bone and joint infections, which are commonly caused by bacteria such as staphylococcus (including MRSA) and streptococcus, are often painful, protracted and disabling.
As well as the inconvenience for patients having to stay in hospital or relying on a specialist nurse to visit the patient at home to administer IV antibiotics, injections pose a risk to patients as they can be complicated by infection or blood clot formation.
The study at 26 UK hospitals found little difference in the failure rate of antibiotics by pills or IV injections given for the first six weeks of treatment.
It found the median length of stay in hospital was 14 days for injections and 11 days for people who took the antibiotics in pill form.
Complications were also less common in patients treated by tablets and the treatment costs were £2,740 cheaper than injections.
The study was led by Oxford University Hospitals NHS Foundation Trust and funded by the National Institute for Health Research Health Technology Assessment Programme.
Chief investigator, Dr Matthew Scarborough, said: “For decades bone and joint infections have been treated primarily through intravenous antibiotics. This is inconvenient for the patient and costly for the health service.
“Our results are good news for the NHS as use of tablet antibiotics will save money whilst helping to prevent antibiotic resistance. It’s also great news for patients because we now know that changing how we give antibiotics can reduce risk, improve safety and give people more control over their treatment.”
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