395 Prosthetic Joint Infection (PJI): Can Effective Outcomes Be Achieved in the Absence of a Formal OPAT Service

Abstract Periprosthetic joint infection (PJI) represents a major complication following joint arthroplasty, associated with considerable morbidity, mortality, and financial impact on the NHS. Optimal management typically requires a combination of surgical intervention—such as debridement or revision—and extended antimicrobial therapy. Outpatient Parenteral Antimicrobial Therapy (OPAT) services have traditionally facilitated this by enabling intravenous treatment outside hospital settings, reducing inpatient days. In Ayrshire and Arran, the absence of a dedicated OPAT service prompted the development of an alternative, flexible model utilizing long-acting oral antimicrobials in conjunction with weekly multidisciplinary team (MDT) meetings to achieve effective infection control. This study provides a preliminary evaluation of outcomes associated with this approach. A retrospective analysis was conducted on all patients with confirmed PJI discussed at the weekly MDT between 2021 and 2022. The primary outcome measure was infection remission at two-year follow-up. Sixty-three patients (29 male, 34 female) were included: 35 with infected knee prostheses and 22 with infected hip prostheses. Fifty-one patients (80.95%) had undergone elective arthroplasty as their index procedure, with the remainder related to trauma. At two years, 53 patients (84.12%) remained infection-free. PJI remains a challenging condition to manage both in terms of clinical decision making and service delivery. Our findings demonstrate that successful infection control can be achieved through precise microbiological diagnosis, tailored antimicrobial selection and multidisciplinary engagement.