How I do it…. How infection doctors approach the PJI MDT

The management of prosthetic joint infection (PJI) requires discussion between experts working towards the aims and expectations of the patient. Each discipline typically does not offer a single-minded approach, but instead collectively weighs up the strengths and weaknesses of different management options. At a basic level, the infection specialist provides antimicrobial solutions based on laboratory results. During multi-disciplinary team (MDT) discussions however, they can offer additional insights into how the microbiology could influence the surgical decisions, respond to the surgical debate by designing a rational approach to antimicrobials and contribute to an option-appraisal that can be presented to the patient. In this short opinion piece, we describe some of the thoughts we have during MDT discussions to ultimately recommend an optimised treatment plan for the individual patient: is there infection? what is the pathogen? where did it come from? (and where else has it gone), and what is the best treatment strategy?