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Clindamycin-rifampin combination therapy for staphylococcal periprosthetic joint infections: a retrospective

Borg Leijtens1, Joris B W Elbers2, Patrick D Sturm3

  • 1Department of Orthopaedic Surgery, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. borg.leijtens@radboudumc.nl.

BMC Infectious Diseases
|May 4, 2017
PubMed
Abstract

Insights

Clindamycin-rifampin combination therapy effectively manages staphylococcal periprosthetic joint infections (PJI), showing a high cure rate and good tolerability. This treatment is a safe option for staphylococcal PJI.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Pharmacology

Background:

  • Staphylococcal species are the primary cause of periprosthetic joint infections (PJI), accounting for over 50% of cases.
  • Rifampin-based combination regimens are recognized as effective antimicrobial therapies for staphylococcal PJI.

Purpose of the Study:

  • To evaluate the safety and efficacy of clindamycin in combination with rifampin for treating staphylococcal PJI.
  • To assess the outcomes of this combination therapy in patients with hip or knee periprosthetic infections.

Main Methods:

  • A retrospective cohort study included patients treated with clindamycin-rifampin for Staphylococcus aureus or coagulase-negative staphylococci PJI.
  • Patients were managed using a standardized treatment algorithm and followed for a median of 54 months.
  • The study included patients undergoing debridement and retention of the implant (DAIR) or revision surgery for presumed aseptic loosening with positive cultures.

Main Results:

  • The clindamycin-rifampin regimen demonstrated an overall success rate of 86% in 36 patients.
  • Cure rates were 78% for DAIR patients and 94% for the revision group.
  • Five patients (14%) discontinued therapy due to side effects, while 94% of those completing the regimen were cured.

Conclusions:

  • Combined clindamycin and rifampin therapy is a safe, well-tolerated, and effective treatment for staphylococcal periprosthetic infections.
  • This regimen offers a viable option for managing challenging staphylococcal PJI cases.
Keywords:
ClindamycinPeriprosthetic joint infectionRifampinStaphylococcus

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