Total knee replacement strep infection

Posted by stony @stony, Jul 22, 2021

8 weeks post knee replacement I was diagnosed with a strep infection. I had a second surgery to perform a washout and then had 6 weeks of ampicillin with a PICC line via an infusion pump. Now I’m on 875 mg of amoxicillin twice a day for 6 months. Is this normal treatment. I seem to be doing okay I am ambulatory but the knee is still fairly sore but then it has been through surgery twice

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@stony Hello and welcome to Connect. I think you might be asking about a staff infection which is a risk with surgery. Those infections can be serious. I do know a woman who had a staff infection after surgery for a broken ankle. She was in a rehab facility for months, and had to keep having surgeries to clean out the infection and have a wound vac attached. I think she may have had 7 surgeries for the infection and the doctors were discussing possible amputation of her foot. One of those surgeries removed the hardware. This went on for about a year and I was visiting her at the rehab home.

Doctors also treat some other types of infections long term with months of antibiotics. One of the big issues of antibiotic treatment is stopping the antibiotics too soon which can lead to antibiotic resistance when some of the infection hasn't been killed off by treatment. There is a reason that the doses are timed and prescribed for a specific number of days to keep the levels of drug high enough to be therapeutic because your body is always working to rid itself of the drugs. Those bacteria can then proliferate freely if the antibiotic treatment is stopped. The existence of antibiotic resistant strains of staff bacteria becomes a real threat when doctors don't have drugs that can kill it because the bacteria has evolved resistance to the drug. This is what doctors are trying to prevent.

Your recommended treatment and antibiotic therapy is specific for you, and every patient is different, so there isn't one answer that is right for everyone. Because pain can indicate an infection, it is best to post that question to your surgeon and discuss your progress. I have not had a knee replacement, so I would like to invite others to share their experience of recovery from this surgery.

Hopefully some of our other members such as @johnbishop will share their experience. Is this your first experience with knee replacement?

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@jenniferhunter

@stony Hello and welcome to Connect. I think you might be asking about a staff infection which is a risk with surgery. Those infections can be serious. I do know a woman who had a staff infection after surgery for a broken ankle. She was in a rehab facility for months, and had to keep having surgeries to clean out the infection and have a wound vac attached. I think she may have had 7 surgeries for the infection and the doctors were discussing possible amputation of her foot. One of those surgeries removed the hardware. This went on for about a year and I was visiting her at the rehab home.

Doctors also treat some other types of infections long term with months of antibiotics. One of the big issues of antibiotic treatment is stopping the antibiotics too soon which can lead to antibiotic resistance when some of the infection hasn't been killed off by treatment. There is a reason that the doses are timed and prescribed for a specific number of days to keep the levels of drug high enough to be therapeutic because your body is always working to rid itself of the drugs. Those bacteria can then proliferate freely if the antibiotic treatment is stopped. The existence of antibiotic resistant strains of staff bacteria becomes a real threat when doctors don't have drugs that can kill it because the bacteria has evolved resistance to the drug. This is what doctors are trying to prevent.

Your recommended treatment and antibiotic therapy is specific for you, and every patient is different, so there isn't one answer that is right for everyone. Because pain can indicate an infection, it is best to post that question to your surgeon and discuss your progress. I have not had a knee replacement, so I would like to invite others to share their experience of recovery from this surgery.

Hopefully some of our other members such as @johnbishop will share their experience. Is this your first experience with knee replacement?

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That's good information however what I have is definitely a Strep infection not staph!

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@stony

That's good information however what I have is definitely a Strep infection not staph!

Jump to this post

@stony Thanks for setting me straight on the type of your infection. I am not a medical professional, but generally it would still be the same discussion regardless of which bacteria caused it. What would be different would be the antibiotics used to treat the infection because those are specific to different kinds of bacteria, and also what strength dosage is needed and for how long. That advice needs to come from a qualified medical professional or possibly a pharamacist. I did find this link that discusses different types of infections after surgery as general information. Thank you for your post and I have learned something today. Perhaps others with similar experiences will share their stories.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections

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Hi @stony, I would like to add my welcome to Connect along with @jenniferhunter and other members. I was fortunate that I did not have any issues or infection following my right knee replacement. @titia131 has posted in another discussion about a staff infection after a TKR and may have some suggestions or experience to share with you. Also, you might want to check out an in-depth conversation between members on that subject here, https://connect.mayoclinic.org/discussion/what-kind-of-mobility-can-i-expect-with-an-antibiotic-spacer-in-my-hip/. Although they may not be talking about a knee replacement specifically, I suspect that many of the issues you are wondering about and have concerns about are similar.

Here are some articles that may help provide some more information and answer some of your questions:
— What You Should Know About Infections After a Knee Replacement: https://www.healthline.com/health/knee-replacement-infection
— Infection after total knee arthroplasty and its gold standard surgical treatment: Spacers used in two-stage revision arthroplasty: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735278/

Has there been any discussion with your doctors about antibiotic spacers?

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