POvIV Trial Journal Club

The JAMA Surgery Network published the POvIV trial in May 2025. This post is a journal club breaking down the POvIV trial and what change it may bring to our clinical practice.

Background/Overview

Title: Oral vs Intravenous Antibiotics for Fracture-Related Infections

Citation: Major Extremity Trauma Research Consortium (METRC). Oral vs Intravenous Antibiotics for Fracture-Related Infections: The POvIV Randomized Clinical Trial. JAMA Surg. Published online January 22, 2025.

Objective: To evaluate the effectiveness of treatment of FRI with 6 weeks of oral vs IV antibiotics

Background: Fracture-related infection (FRI) is a common and serious complication following fracture fixation surgery. Current FRI treatment regimens throughout North America and Europe require patients with infections to receive prolonged intravenous (IV) antibiotic therapy for 6 weeks or more following surgical debridement. Emerging literature supports successful use of lower-cost oral antibiotic therapy for the management of adult and pediatric infections for shorter duration of IV antibiotics and overall shorter duration of all antibiotics.

Primary Efficacy Measure: number of study injury-related surgical interventions within 1 year after discharge from the initial infection hospitalization