Antimicrobial treatment of orthopedic implant-related infections with rifampin combinations.
The purpose of this prospective clinical study is to evaluate the role of combination chemotherapy with rifampin in the treatment of orthopedic device-related infections in which the implant could not be removed. Eleven patients with orthopedic implant-related infections due to staphylococci or streptococci were treated with the implant in situ. Each antimicrobial regimen included rifampin in combination with a beta-lactam antibiotic or ciprofloxacin. The median duration of treatment with rifampin was 86 days (range, 15-336 days) with a median follow-up of greater than 24 months after cessation of therapy. Treatment was successful for 82% of patients. Failures were associated with documented inappropriate treatment. These preliminary clinical data are supported by data from in vitro studies and animal experiments. Combination therapy with rifampin, in particular rifampin and a quinolone, should be considered for patients with orthopedic implant-related infections if the implant cannot be removed.
Widmer
A F
AF
Division of Infectious Diseases, University Hospital, Basel, Switzerland.
Gaechter
A
A
Ochsner
P E
PE
Zimmerli
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012293:Rifampin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology
D012293:Rifampin