Anti-bacterial injection after aspiration of pus in a non-prosthetic joint - a scoping review v1

Objective: The objective of this scoping review is to report the current extent and use of local antibacterial intraarticular agents in treating native joint infections. Introduction: Septic arthritis (SA) is a severe joint infection that can lead to rapid joint destruction and systemic illness, if not addressed in the acute phase. Native joint septic arthritis (NJSA) is associated with significant morbidity, particularly in elderly patients and in those with comorbidities. Increasing incidence rates, affected by aging populations and arthroscopic interventions, underscore the need for optimized treatment strategies. This scoping review explores the use of antibacterial agents as a primary intraarticular treatment for infected native joints, potentially reporting literature, that in later stages can offer an alternative to immediate surgical intervention. Inclusion criteria: All in vivo studies, both human and animal, with intraarticular treatment of native joints with an antibacterial agent were included. Studies with prosthetic joints or studies in other languages than English or Scandinavian will be excluded. Methods: A comprehensive literature search was conducted in PubMed, MEDLINE, Clinical Trials and Web of Science, limited to studies published in English or Scandinavian. Eligible studies includes both animal and human research evaluating the use of antibacterial agents for native joint septic arthritis. Titles and abstracts will be screened independently by two reviewers, followed by full-text review for inclusion. Data will be extracted and synthesized descriptively, focusing on type of antibacterial agent used, treatment outcomes, and study design. Results: All included studies will be presented in an overview table and addressed separately in the result section. The table will include: Citation and year, population (country and number of participants n=), joint, diagnostic criteria, injected or arthroscopically treated, type of antibacterial agent and reason for choice, timeframe for intraarticular treatment, control group, results, additional surgery (yes/no), bacterial agent, side effects, prior antibiotic treatment, admission time, mortality, failure rate and criteria. All included studies will be compared and gathered in groups in the result section. Results from clinical and experimental studies will be divided. Conclusions: The authors will comment on the tendencies of the study, and the knowledge that has been gathered in conducting this review.