Efficacy and Safety of Rifampin Containing Regimen for Staphylococcal Prosthetic Joint Infections Treated with Debridement and Retention

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 2010 May 28

PMID 20505968

Citations 47

Authors

O C El Helou

E F Berbari

B D Lahr

J E Eckel-Passow

R R Razonable

I G Sia

A Virk

R C Walker

J M Steckelberg

W R Wilson

A D Hanssen

D R Osmon

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to evaluate the efficacy and safety of rifampin for Staphylococcus aureus (SA) or coagulase negative staphylococci (CNS) prosthetic joint infection (PJI) treated with debridement and retention (D/R). We calculated the treatment failure cumulative incidence (TF) of a cohort of 101 patients with SA or CNS PJI treated with D/R and antimicrobial therapy. The effect of the use of a rifampin-based regimen was evaluated. Cox proportional hazards regression evaluated the association between treatment and time-to-TF controlling for the propensity to treat with rifampin and temporal confounders. Seven percent (1/14) of the prospective rifampin-treated patients, 32% (10/31) of the historical rifampin-treated patients and 38% (21/56) of the historical non-rifampin treated patients developed TF. After controlling for the propensity to treat with rifampin and American Society of Anesthesia scores, patients in the prospective cohort had a lower risk of TF compared to patients in the historical cohort not treated with rifampin (HR 0.11; 95%CI 0.01-0.84). None (0/14) of the patients in the prospective study developed hepatotoxicity. The outcome of staphylococcal PJI treated with D/R and rifampin-based regimens was better when compared with a historical cohort treated without rifampin.

Citing Articles

The Role of Rifampin in Prosthetic Joint Infections: Efficacy, Challenges, and Clinical Evidence.

Pupaibool J Antibiotics (Basel). 2025; 13(12.

PMID: 39766613 PMC: 11727642. DOI: 10.3390/antibiotics13121223.

Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFire System within a Time-Dependent and Bacterium-Dependent Protocol: Review and Prosthesis-Saving Protocol.

Sangaletti R, Andriollo L, Montagna A, Franzoni S, Colombini P, Perticarini L Biomedicines. 2024; 12(9).

PMID: 39335595 PMC: 11428812. DOI: 10.3390/biomedicines12092082.

Early Staphylococcal Periprosthetic Joint Infection (PJI) Treated with Debridement, Antibiotics, and Implant Retention (DAIR): Inferior Outcomes in Patients with Staphylococci Resistant to Rifampicin.

Eriksson H, Lazarinis S, Jarhult J, Hailer N Antibiotics (Basel). 2023; 12(11).

PMID: 37998791 PMC: 10668653. DOI: 10.3390/antibiotics12111589.

Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections-A Prospective Study with a Special Focus on Rifampin.

Reinecke P, Morovic P, Niemann M, Renz N, Perka C, Trampuz A Antibiotics (Basel). 2023; 12(11).

PMID: 37998762 PMC: 10668752. DOI: 10.3390/antibiotics12111560.

Principles of mechanical and chemical debridement with implant retention.

Deckey D, Christopher Z, Bingham J, Spangehl M Arthroplasty. 2023; 5(1):16.

PMID: 37020248 PMC: 10077701. DOI: 10.1186/s42836-023-00170-x.

References

Stewart P, Costerton J . Antibiotic resistance of bacteria in biofilms. Lancet. 2001; 358(9276):135-8. DOI: 10.1016/s0140-6736(01)05321-1. View

Fisman D, Reilly D, Karchmer A, Goldie S . Clinical effectiveness and cost-effectiveness of 2 management strategies for infected total hip arthroplasty in the elderly. Clin Infect Dis. 2001; 32(3):419-30. DOI: 10.1086/318502. View

Berbari E, Osmon D, Duffy M, Harmssen R, Mandrekar J, Hanssen A . Outcome of prosthetic joint infection in patients with rheumatoid arthritis: the impact of medical and surgical therapy in 200 episodes. Clin Infect Dis. 2005; 42(2):216-23. DOI: 10.1086/498507. View

Soriano A, Garcia S, Bori G, Almela M, Gallart X, Macule F . Treatment of acute post-surgical infection of joint arthroplasty. Clin Microbiol Infect. 2006; 12(9):930-3. DOI: 10.1111/j.1469-0691.2006.01463.x. View

Kurland L, Molgaard C . The patient record in epidemiology. Sci Am. 1981; 245(4):54-63. DOI: 10.1038/scientificamerican1081-54. View

Choong P, Dowsey M, Carr D, Daffy J, Stanley P . Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen. Acta Orthop. 2008; 78(6):755-65. DOI: 10.1080/17453670710014527. View

Barberan J . Management of infections of osteoarticular prosthesis. Clin Microbiol Infect. 2006; 12 Suppl 3:93-101. DOI: 10.1111/j.1469-0691.2006.01400.x. View

Tsukayama D, Wicklund B, Gustilo R . Suppressive antibiotic therapy in chronic prosthetic joint infections. Orthopedics. 1991; 14(8):841-4. DOI: 10.3928/0147-7447-19910801-07. View

Harris L, Geoff Richards R . Staphylococci and implant surfaces: a review. Injury. 2006; 37 Suppl 2:S3-14. DOI: 10.1016/j.injury.2006.04.003. View

10.

Barberan J, Aguilar L, Carroquino G, Gimenez M, Sanchez B, Martinez D . Conservative treatment of staphylococcal prosthetic joint infections in elderly patients. Am J Med. 2006; 119(11):993.e7-10. DOI: 10.1016/j.amjmed.2006.03.036. View

11.

Crockarell J, Hanssen A, Osmon D, Morrey B . Treatment of infection with débridement and retention of the components following hip arthroplasty. J Bone Joint Surg Am. 1998; 80(9):1306-13. DOI: 10.2106/00004623-199809000-00009. View

12.

Aboltins C, Page M, Buising K, Jenney A, Daffy J, Choong P . Treatment of staphylococcal prosthetic joint infections with debridement, prosthesis retention and oral rifampicin and fusidic acid. Clin Microbiol Infect. 2007; 13(6):586-91. DOI: 10.1111/j.1469-0691.2007.01691.x. View

13.

Zimmerli W, Widmer A, Blatter M, Frei R, Ochsner P . Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. JAMA. 1998; 279(19):1537-41. DOI: 10.1001/jama.279.19.1537. View

14.

Kurtz S, Lau E, Halpern M, Ong K . Trend shows growing orthopedic surgery case load. Will surgeons be able to keep up?. Mater Manag Health Care. 2006; 15(7):61-2. View

15.

Marculescu C, Berbari E, Hanssen A, Steckelberg J, Harmsen S, Mandrekar J . Outcome of prosthetic joint infections treated with debridement and retention of components. Clin Infect Dis. 2006; 42(4):471-8. DOI: 10.1086/499234. View

16.

Schrenzel J, Harbarth S, Schockmel G, Genne D, Bregenzer T, Flueckiger U . A randomized clinical trial to compare fleroxacin-rifampicin with flucloxacillin or vancomycin for the treatment of staphylococcal infection. Clin Infect Dis. 2004; 39(9):1285-92. DOI: 10.1086/424506. View

17.

Berbari E, Marculescu C, Sia I, Lahr B, Hanssen A, Steckelberg J . Culture-negative prosthetic joint infection. Clin Infect Dis. 2007; 45(9):1113-9. DOI: 10.1086/522184. View

18.

Murillo O, Domenech A, Garcia A, Tubau F, Cabellos C, Gudiol F . Efficacy of high doses of levofloxacin in experimental foreign-body infection by methicillin-susceptible Staphylococcus aureus. Antimicrob Agents Chemother. 2006; 50(12):4011-7. PMC: 1693998. DOI: 10.1128/AAC.00523-06. View

19.

Giulieri S, Graber P, Ochsner P, Zimmerli W . Management of infection associated with total hip arthroplasty according to a treatment algorithm. Infection. 2004; 32(4):222-8. DOI: 10.1007/s15010-004-4020-1. View

20.

Zhan C, Kaczmarek R, Loyo-Berrios N, Sangl J, Bright R . Incidence and short-term outcomes of primary and revision hip replacement in the United States. J Bone Joint Surg Am. 2007; 89(3):526-33. DOI: 10.2106/JBJS.F.00952. View