Treatment of staphylococcal implant infection with rifampicin-ciprofloxacin in stable implants.
Infection following total joint replacement remains a problem that has not been solved so far. The treatment options include removal of the implant and a delayed reconstruction or a direct exchange operation. Among patients with stable implants and short duration of infection as well as in patients who for certain reasons are inoperable, antibiotic therapy with a combination of rifampicin-ciprofloxacin may be a reasonable treatment option for curing staphyloccocal infection without removal of the implant. A case study of a Staphylococcus epidermidis (coagulase-negative) infection following delayed revision total knee replacement after septic loosening of a knee arthroplasty and its successful conservative treatment with rifampicin-ciprofloxacin is described. Alternative rifampicin combinations are discussed with respect to recently developed pharmacodynamical and pharmacokinetical findings of biofilm active drugs.
König
D P
DP
Department of Orthopaedic Surgery, Cologne University, Germany.
Schierholz
J M
JM
Münnich
U
U
Rütt
J
J
D000900:Anti-Bacterial Agents; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003646:Debridement; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000097:blood / Q000188:drug therapy*; D012086:Reoperation; D012293:Rifampin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013212:Staphylococcus epidermidis
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002097:C-Reactive Protein; D012293:Rifampin