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Daptomycin versus Vancomycin as Post-Operative Empirical Antibiotic Treatment for Prosthetic Joint Infections: A

C Joseph1, O Robineau2,3, M Titecat3,4

  • 1Infectious Diseases Department, University Hospital of Amiens, France.

Journal of Bone and Joint Infection
|April 24, 2019
PubMed

Insights

Vancomycin (Van) and Daptomycin (Dap) show similar efficacy for post-operative empirical antibiotic treatment (PEAT) in periprosthetic joint infections (PJIs). However, Vancomycin had a higher discontinuation rate due to adverse events.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Pharmacology

Background:

  • Periprosthetic joint infections (PJIs) are serious complications following joint replacement surgery.
  • Empirical antibiotic treatment is crucial in the post-operative period before culture results are available.

Purpose of the Study:

  • To compare the safety and efficacy of Vancomycin versus Daptomycin as post-operative empirical antibiotic treatment (PEAT) for PJIs.
  • To evaluate adverse events and treatment discontinuation rates associated with each antibiotic.

Main Methods:

  • Retrospective review of medical charts for patients with PJIs treated with Vancomycin or Daptomycin.
  • Patients received empirical treatment combined with cefotaxime, cefepime, or aztreonam.
  • Matched cohort analysis comparing 20 patients on Daptomycin with 20 patients on Vancomycin.

Main Results:

  • No significant differences in pathogen distribution or ASA scores between groups.
  • Vancomycin treatment was discontinued due to adverse events in 5 patients, compared to none in the Daptomycin group (P=0.02).
  • Similar infection remission rates were observed at follow-up (36 patients in remission), with 2 treatment failures in each group.

Conclusions:

  • Post-operative empirical antibiotic treatment with Vancomycin for septic revision of PJIs is associated with a higher rate of discontinuation due to adverse events.
  • Daptomycin offers a comparable clinical outcome to Vancomycin with a potentially better safety profile in this context.
Keywords:
DaptomycinVancomycinempirical antibiotic treatmentprosthetic joint infection

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