Journal of Antimicrobial Chemotherapy, Vol 39, 235-240, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
M Drancourt, A Stein, JN Argenson, R Roiron, P Groulier and D Raoult
Oral therapy of staphylococcal infection of orthopaedic implants with 900
mg/day rifampicin combined with either 1.5 g/day fusidic acid for 5 days
followed by 1 g/day thereafter, or 600 mg/day ofloxacin was compared.
Patients with an infected hip were treated for 6 months, with removal of
any unstable prosthesis after 5 months' treatment and those with an
infected knee prosthesis were treated for 9 months, with removal of the
prosthesis after 6 months of treatment. Patients with infections of other
type of bone implants were treated for 6 months with removal of the implant
after 3 months of treatment, if necessary. Cure was defined as the absence
of clinical, microbiological and radiological evidence of infection 12
months after completion of treatment. The treatment of 46 of the 52
included in the study was evaluated for safety and that of 42 was assessed
for efficacy. Overall treatment was successful for 11 (55%) of 20 patients
treated with rifampicin and fusidic acid group and for 11 (50%) of the 22
treated with rifampicin and ofloxacin. Treatment failed in four cases in
each treatment group because of persistent infection. One patient given
rifampicin and fusidic acid and three patients given rifampicin and
ofloxacin failed treatment because of relapse. Superinfection led to
failure in the remainder and was due to staphylococci in all but one case
in which Acinetobacter calcoaceticus var. anitratus was isolated. There
were no side effects related to study treatment. Oral treatment with
rifampicin combined with fusidic acid may be a suitable alternative to the
combination of rifampicin and ofloxacin for treating implant infections due
to Staphylococcus spp. either when the patient is intolerant to quinolones
or when the infecting organism is resistant to these drugs.
JOURNAL ARTICLE
Oral treatment of Staphylococcus spp. infected orthopaedic implants with fusidic acid or ofloxacin in combination with rifampicin
Laboratoire de Microbiologie Clinique, Hopital de la Timone, Marseille, France.
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