Treatment of acute post-surgical infection of joint arthroplasty

Clin Microbiol Infect. 2006 Sep;12(9):930-3. doi: 10.1111/j.1469-0691.2006.01463.x.

Abstract

The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the implant, has not been well-defined. This study describes the use of a protocol based on oral rifampicin combinations to treat 47 cases that were followed prospectively for a 2-year period. The regimen used most commonly was levofloxacin 500 mg/24 h plus rifampicin 600 mg/24 h for a mean duration of 2.7 +/- 1 months. The cure rate was 76.9%, and the only independent risk-factor associated with treatment failure was infection caused by methicillin-resistant Staphylococcus aureus or Enterococcus spp. (OR 17.6, p 0.003). Overall, the results suggested that use of oral antibiotics, including rifampicin, for 2-3 months was a good treatment option.

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Debridement
  • Drug Therapy, Combination
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Positive Cocci / drug effects
  • Humans
  • Levofloxacin*
  • Male
  • Ofloxacin / administration & dosage
  • Ofloxacin / therapeutic use*
  • Prosthesis-Related Infections / drug therapy*
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Ofloxacin
  • Rifampin