Oral Antibiotic Therapy for Shoulder Periprosthetic Joint Infection: Current and Evolving Concepts.

Fernainy, Christopher; Randhawa, Amritpal S; Frederickson, Matthew; Menendez, Mariano E · JB JS Open Access · 2026

review · Level V

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Abstract

» Conventional treatment of shoulder periprosthetic joint infection (PJI) consists of prolonged intravenous (IV) antibiotics injected into a PICC line. This method can be associated with adverse events such as catheter-related infections, extended hospitalizations, and higher medical costs. » The OVIVA trial demonstrated that oral antibiotics are no less effective than IV antibiotics as previously thought for complex orthopedic infections. These findings have sparked interest in the use of oral antibiotics for shoulder PJI. » Current data on the use of oral antibiotics in shoulder PJI is limited but growing. A number of studies assess the effects of oral antibiotic therapy on the shoulder, with most being small and retrospective. » Early evidence in shoulder PJI suggests that oral antibiotic therapy may provide satisfactory outcomes in select cases, though confirmation in high-quality, multicenter trials is essential.

Anatomy