Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study
Abstract Background Linezolid (LZD) and daptomycin (DAP) are predominantly used to target gram-positive pathogens; however, treatment effectiveness and adverse reactions for periprosthetic joint infections (PJIs) remain unknown. The aim of this study was to compare the effectiveness and adverse reac...
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1375-7 |
| _version_ | 1828154009104416768 |
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| author | Masahiro Sawada Kenichi Oe Masayuki Hirata Hiroshi Kawamura Narumi Ueda Tomohisa Nakamura Hirokazu Iida Takanori Saito |
| author_facet | Masahiro Sawada Kenichi Oe Masayuki Hirata Hiroshi Kawamura Narumi Ueda Tomohisa Nakamura Hirokazu Iida Takanori Saito |
| author_sort | Masahiro Sawada |
| collection | DOAJ |
| description | Abstract Background Linezolid (LZD) and daptomycin (DAP) are predominantly used to target gram-positive pathogens; however, treatment effectiveness and adverse reactions for periprosthetic joint infections (PJIs) remain unknown. The aim of this study was to compare the effectiveness and adverse reactions of LZD and DAP for PJIs. Methods This study retrospectively evaluated 82 patients between June 2009 and December 2017, to compare the effectiveness of LZD (group L, n = 39) and DAP (group D, n = 43) for treatment of PJIs harboring gram-positive microorganisms. Surgical options used with LZD or DAP therapy included implant retention, implant removal, and a shift to another appropriate antibiotic. Infection control was defined as not requiring implant removal after the final treatment. Results Gram-positive pathogens were isolated from 72% of group L and 70% of group D patients, respectively. Whole infection control rates against gram-positive pathogens in groups L and D were 79% and 77%, respectively. Furthermore, infection control rates were 94% and 58% in group L and 75% and 80% in group D, without and with implant removal, respectively. Significantly higher clinical success rates and lower adverse event rates were observed in group D, including higher red blood cell and platelet counts and lower C-reactive protein (CRP) levels. Conclusions Although the effectiveness of LZD and DAP was equivalent in terms of infection control rates for refractory PJIs with gram-positive pathogens, DAP therapy significantly decreased CRP levels and caused fewer adverse events than LZD treatment. |
| first_indexed | 2024-04-11T22:33:03Z |
| format | Article |
| id | doaj.art-877291be6e44405a9a555680177877ed |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:33:03Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-877291be6e44405a9a555680177877ed2022-12-22T03:59:17ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-10-011411810.1186/s13018-019-1375-7Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort studyMasahiro Sawada0Kenichi Oe1Masayuki Hirata2Hiroshi Kawamura3Narumi Ueda4Tomohisa Nakamura5Hirokazu Iida6Takanori Saito7Department of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityAbstract Background Linezolid (LZD) and daptomycin (DAP) are predominantly used to target gram-positive pathogens; however, treatment effectiveness and adverse reactions for periprosthetic joint infections (PJIs) remain unknown. The aim of this study was to compare the effectiveness and adverse reactions of LZD and DAP for PJIs. Methods This study retrospectively evaluated 82 patients between June 2009 and December 2017, to compare the effectiveness of LZD (group L, n = 39) and DAP (group D, n = 43) for treatment of PJIs harboring gram-positive microorganisms. Surgical options used with LZD or DAP therapy included implant retention, implant removal, and a shift to another appropriate antibiotic. Infection control was defined as not requiring implant removal after the final treatment. Results Gram-positive pathogens were isolated from 72% of group L and 70% of group D patients, respectively. Whole infection control rates against gram-positive pathogens in groups L and D were 79% and 77%, respectively. Furthermore, infection control rates were 94% and 58% in group L and 75% and 80% in group D, without and with implant removal, respectively. Significantly higher clinical success rates and lower adverse event rates were observed in group D, including higher red blood cell and platelet counts and lower C-reactive protein (CRP) levels. Conclusions Although the effectiveness of LZD and DAP was equivalent in terms of infection control rates for refractory PJIs with gram-positive pathogens, DAP therapy significantly decreased CRP levels and caused fewer adverse events than LZD treatment.http://link.springer.com/article/10.1186/s13018-019-1375-7LinezolidDaptomycinPeriprosthetic joint infectionImplant retentionAdverse event rates |
| spellingShingle | Masahiro Sawada Kenichi Oe Masayuki Hirata Hiroshi Kawamura Narumi Ueda Tomohisa Nakamura Hirokazu Iida Takanori Saito Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study Journal of Orthopaedic Surgery and Research Linezolid Daptomycin Periprosthetic joint infection Implant retention Adverse event rates |
| title | Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study |
| title_full | Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study |
| title_fullStr | Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study |
| title_full_unstemmed | Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study |
| title_short | Linezolid versus daptomycin treatment for periprosthetic joint infections: a retrospective cohort study |
| title_sort | linezolid versus daptomycin treatment for periprosthetic joint infections a retrospective cohort study |
| topic | Linezolid Daptomycin Periprosthetic joint infection Implant retention Adverse event rates |
| url | http://link.springer.com/article/10.1186/s13018-019-1375-7 |
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