Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial
Abstract Background The evidence supporting rifampin combination therapy in prosthetic joint infections (PJI) is limited due to the lack of controlled studies. The aim of this study is to evaluate the effect of adding rifampin to conventional antimicrobial therapy in early staphylococcal PJIs treate...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01877-2 |
| _version_ | 1811263203470999552 |
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| author | Øystein Espeland Karlsen Pål Borgen Bjørn Bragnes Wender Figved Bjarne Grøgaard Jonas Rydinge Lars Sandberg Finnur Snorrason Helge Wangen Eivind Witsøe Marianne Westberg |
| author_facet | Øystein Espeland Karlsen Pål Borgen Bjørn Bragnes Wender Figved Bjarne Grøgaard Jonas Rydinge Lars Sandberg Finnur Snorrason Helge Wangen Eivind Witsøe Marianne Westberg |
| author_sort | Øystein Espeland Karlsen |
| collection | DOAJ |
| description | Abstract Background The evidence supporting rifampin combination therapy in prosthetic joint infections (PJI) is limited due to the lack of controlled studies. The aim of this study is to evaluate the effect of adding rifampin to conventional antimicrobial therapy in early staphylococcal PJIs treated with debridement and retention of the implant (DAIR). Methods In this multicenter randomized controlled trial, 99 patients with PJI after hip and knee arthroplasties were enrolled. They were randomly assigned to receive rifampin or not in addition to standard antimicrobial treatment with cloxacillin or vancomycin in case of methicillin resistance. The primary endpoint was no signs of infection after 2 years of follow-up. Results Forty-eight patients were included in the final analyses. There were no differences in patient characteristics or comorbidities between the two groups. There was no significant difference in remission rate between the rifampin combination group (17 of 23 (74%)) and the monotherapy group (18 of 25 (72%), relative risk 1.03, 95% confidence interval 0.73 to 1.45, p = 0.88). Conclusion This trial has not proven a statistically significant advantage by adding rifampin to standard antibiotic treatment in acute staphylococcal PJIs. Trial registration The Regional Ethics Committee and the Norwegian Medicines Agency approved the study (EudraCT 2005-005494-29), and the study was registered at ClinicalTrials.gov at Jan 18, 2007 ( NCT00423982 ). |
| first_indexed | 2024-04-12T19:40:30Z |
| format | Article |
| id | doaj.art-0d000e3ed04a4eb99bca965aedaeae32 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-12T19:40:30Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-0d000e3ed04a4eb99bca965aedaeae322022-12-22T03:19:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-08-011511910.1186/s13018-020-01877-2Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trialØystein Espeland Karlsen0Pål Borgen1Bjørn Bragnes2Wender Figved3Bjarne Grøgaard4Jonas Rydinge5Lars Sandberg6Finnur Snorrason7Helge Wangen8Eivind Witsøe9Marianne Westberg10Division of Orthopaedic Surgery, Oslo University HospitalDepartment of Orthopaedic Surgery, Martina Hansen HospitalDepartment of Orthopaedic Surgery, Vestre Viken HFDepartment of Orthopaedic Surgery, Bærum HospitalDivision of Orthopaedic Surgery, Oslo University HospitalDivision of Orthopaedic Surgery, Oslo University HospitalDepartment of Orthopaedic Surgery, Sykehuset Innlandet HFDivision of Orthopaedic Surgery, Oslo University HospitalDepartment of Orthopaedic Surgery, Sykehuset Innlandet HFDepartment of Orthopaedic Surgery, St. Olavs HospitalDivision of Orthopaedic Surgery, Oslo University HospitalAbstract Background The evidence supporting rifampin combination therapy in prosthetic joint infections (PJI) is limited due to the lack of controlled studies. The aim of this study is to evaluate the effect of adding rifampin to conventional antimicrobial therapy in early staphylococcal PJIs treated with debridement and retention of the implant (DAIR). Methods In this multicenter randomized controlled trial, 99 patients with PJI after hip and knee arthroplasties were enrolled. They were randomly assigned to receive rifampin or not in addition to standard antimicrobial treatment with cloxacillin or vancomycin in case of methicillin resistance. The primary endpoint was no signs of infection after 2 years of follow-up. Results Forty-eight patients were included in the final analyses. There were no differences in patient characteristics or comorbidities between the two groups. There was no significant difference in remission rate between the rifampin combination group (17 of 23 (74%)) and the monotherapy group (18 of 25 (72%), relative risk 1.03, 95% confidence interval 0.73 to 1.45, p = 0.88). Conclusion This trial has not proven a statistically significant advantage by adding rifampin to standard antibiotic treatment in acute staphylococcal PJIs. Trial registration The Regional Ethics Committee and the Norwegian Medicines Agency approved the study (EudraCT 2005-005494-29), and the study was registered at ClinicalTrials.gov at Jan 18, 2007 ( NCT00423982 ).http://link.springer.com/article/10.1186/s13018-020-01877-2RifampinStaphylococciProsthetic joint infectionSurgery |
| spellingShingle | Øystein Espeland Karlsen Pål Borgen Bjørn Bragnes Wender Figved Bjarne Grøgaard Jonas Rydinge Lars Sandberg Finnur Snorrason Helge Wangen Eivind Witsøe Marianne Westberg Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial Journal of Orthopaedic Surgery and Research Rifampin Staphylococci Prosthetic joint infection Surgery |
| title | Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial |
| title_full | Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial |
| title_fullStr | Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial |
| title_full_unstemmed | Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial |
| title_short | Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial |
| title_sort | rifampin combination therapy in staphylococcal prosthetic joint infections a randomized controlled trial |
| topic | Rifampin Staphylococci Prosthetic joint infection Surgery |
| url | http://link.springer.com/article/10.1186/s13018-020-01877-2 |
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