title: High doses of daptomycin (10 mg/kg/d) plus rifampin for the treatment of staphylococcal prosthetic joint infection managed with implant retention: a comparative study.
abstract: We aimed to analyze the efficacy and safety of high doses of daptomycin (10 mg/kg/d) plus rifampin (D10 + R) for prosthetic joint infection (PJI). This was an observational retrospective multicenter study (2010-2012) including all patients with acute PJI by fluoroquinolone-resistant staphylococci managed with implant retention and D10 + R. Twenty cases were included: 2 (10%) were withdrawn due to toxicity, leaving 18 cases for efficacy evaluation: 13 (72%) women, age 79 years (range 58-90). Clinical failure was observed in 9 (50%) patients: in 5 cases, staphylococci were recovered (28% of microbiological failures); no modification of daptomycin-MIC was observed. These 18 cases were compared with 44 matched historical cases: failure rate was similar, but whereas in the historical series, failure occurred fundamentally during therapy, in the present series, it was recorded after discontinuation of antibiotics. In summary, D10 + R may be the initial treatment of choice for PJI by fluoroquinolone-resistant staphylococci managed with implant retention.
authors.affiliation: Department of Infectious Diseases, Hospital Univ. de Bellvitge, Universidad de Barcelona, Barcelona, Spain. Electronic address: jaime@lora-tamayo.es.
authors.forename: Jaime
authors.initials: J
authors.lastname: Lora-Tamayo
authors.affiliation: Department of Infectious Diseases, Hospital Universitario San Cecilio, Granada, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Parra-Ruiz
authors.affiliation: Department of Infectious Diseases, Hospital Univ. Valld'Hebron, Barcelona, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Rodríguez-Pardo
authors.affiliation: Department of Internal Medicine, Hospital Cental de la Defensa, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Barberán
authors.affiliation: Department of Infectious Diseases, Hospital Univ. de Bellvitge, Universidad de Barcelona, Barcelona, Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Ribera
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Clínic Provincial, Barcelona, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tornero
authors.affiliation: Department of Infectious Diseases, Hospital Univ. Valld'Hebron, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Pigrau
authors.affiliation: Department of Infectious Diseases, Hospital Clínic Provincial, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Mensa
authors.affiliation: Department of Infectious Diseases, Hospital Univ. de Bellvitge, Universidad de Barcelona, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Ariza
authors.affiliation: Department of Infectious Diseases, Hospital Clínic Provincial, Barcelona, Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017576:Daptomycin / Q000008:administration & dosage*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin; D012293:Rifampin
keywords: Biofilm; Combined therapy; DAIR; Fluoroquinolone-resistance; Orthopedic device infection