Current standard management of orthopaedic infections includes surgery plus ≥4 weeks of systemic antibiotic therapy. An open-label, multi-country trial investigated whether a local-antibiotic carrier implanted at the infection site during surgery could reduce the duration of systemic antibiotics. Of 475 adult participants who underwent surgery plus local antibiotic implantation, 241 received ≥4 weeks postoperative systemic antibiotics and 234 received ≤7 days postoperative systemic antibiotics. Treatment failure within 12 months occurred in 34 patients (14·1%) of 241 in the ≥4 weeks antibiotic group and in 26 patients (11·1%) of 234 in the ≤7 days antibiotic group (risk difference −3·0 percentage points [non-inferiority margin 10], 95% CI −9·0 to 3·0), highlighting that a short course of antibiotics was non-inferior to a long course.
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