Periprosthetic joint infection (PJI) is a rare but devastating complication after total joint arthroplasty. An estimated 7–12% of patients have negative cultures despite clear clinical evidence of infection. One oft-cited reason for this occurrence is the administration of antibiotics in the weeks prior to obtaining cultures. This article reviews the influence of antibiotics on the diagnosis of PJI. Specifically, we examine the effect of prophylactic and therapeutic antibiotic administration on the diagnostic accuracy of microbiological cultures as well as serum and synovial biomarkers. We also explore the potential of molecular techniques in overcoming these limitations in patients who have received antibiotics before specimen collection and propose areas for future research.

中文翻译：

---

在为膝盖肿胀开抗生素之前，要三思：抗生素对假体周围感染的诊断影响

假体周围关节感染（PJI）是全关节置换术后罕见但具有破坏性的并发症。尽管有明确的临床感染证据，但估计有7-12％的患者培养阴性。引起这种情况的一个经常被提及的原因是在获得培养物之前的几周内施用了抗生素。本文回顾了抗生素对PJI诊断的影响。具体来说，我们研究了预防性和治疗性抗生素给药对微生物培养物以及血清和滑膜生物标志物诊断准确性的影响。我们还探索了分子技术在克服样本收集前已接受抗生素的患者中这些局限性方面的潜力，并提出了需要进一步研究的领域。