JAC Advance Access originally published online on March 31, 2004
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Journal of Antimicrobial Chemotherapy (2004) 53, 887
© 2004 The British Society for Antimicrobial Chemotherapy
Correspondence |
Reply
1 Orthopaedic Clinic and 2 Division of Infectious Diseases, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland; 3 Division of Infectious Diseases, Garches University Hospital, France
Keywords: prosthetic joint infections, orthopaedic, prosthetic infections, treatment
Dear Sir,
We thank Parra-Ruiz et al.1 for their useful comments on alternative antimicrobial therapy for orthopaedic prosthetic infections (OPIs) due to methicillin-resistant Staphylococcus aureus (MRSA) or Staphylococcus epidermidis (MRSE). These infections are protracted and difficult to treat. In our article,2 we indicate that glycopeptides (vancomycin, teicoplanin) remain the primary drugs that should be used for this indication.3 The combinations of fusidic acid (or quinolone)4–rifampicin5 and trimethoprim–sulfamethoxazole6 for susceptible strains have been successfully used in OPI.
We clearly need more new drugs to treat MRSA infection. As discussed by Parra-Ruiz et al.,1 both quinupristin–dalfopristin and linezolid are interesting alternatives, but unfortunately, there is only limited clinical experience with these compounds in osteomyelitis or OPI. Peripheral vein toxicity with quinupristin–dalfopristin and secondary effects upon prolonged therapy with linezolid7 are serious concerns.
Daptomycin8 has recently been approved for the therapy of skin and soft tissue infections. Novel glycopeptides such as dalbavancin9 and a novel cephalosporin active against MRSA activity10 are promising drugs under development.
Footnotes
* Corresponding author. Tel: +41-22-372-33-11; Fax: +41-22-372-77-91: E-mail: daniel.lew{at}hcuge.ch 
References
1 . Parra-Ruiz, J., Martinez, M., Antelo-Lorenzo, R. et al. (2004). Antimicrobials in the treatment of orthopaedic prosthetic infections. Journal of Antimicrobial Chemotherapy 53, DOI: 10.1093/jac/dkh186.
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Bernard, L., Hoffmeyer, P., Assal, M. et al. (2004). Trends in the treatment of orthopaedic prosthetic infections. Journal of Antimicrobial Chemotherapy 53, 127–9.
3 . Bernard, L., El-Hajj, L., Pron, B. et al. (2001). Outpatient parenteral antimicrobial therapy (OPAT) for the treatment of osteomyelitis: evaluation of efficacy, tolerance and cost. Journal of Clinical Pharmacy and Therapeutics 26, 445–51.[CrossRef][Web of Science][Medline]
4 . Stein, A., Drancourt, M. & Raoult, D. (2000). Ambulatory management of infected orthopaedic implants. In Infections Associated with Indwelling Medical Devices (Waldvogel, F. A. & Bisno, A. L., Eds), pp. 211–30. ASM Press, Washington, DC, USA.
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Drancourt, M., Stein, A., Argenson, J. N. et al. (1997). Oral treatment of Staphylococcus spp. infected orthopaedic implants with fusidic acid or ofloxacin in combination with rifampicin. Journal of Antimicrobial Chemotherapy 39, 235–40.
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Stein, A., Bataille, J. F., Drancourt, M. et al. (1998). Ambulatory treatment of multidrug-resistant Staphylococcus-infected orthopedic implants with high-dose oral co-trimoxazole (trimethoprim–sulfamethoxazole). Antimicrobial Agents and Chemotherapy 42, 3086–91.
7 . Bernard, L., Stern, R., Lew, D. et al. (2003). Serotonin syndrome after concomitant treatment with linezolid and citalopram. Clinical Infectious Diseases 36, 1274–5.
8 . Anonymous. (2004). Daptomycin (Cubicin) for skin and soft tissue infections. Medical Letter on Drugs and Therapeutics 46, 11–2.[Medline]
9 . Seltzer, E., Dorr, M. B., Goldstein, B. P. et al. (2003). Once-weekly dalbavancin versus standard-of-care antimicrobial regimens for treatment of skin and soft-tissue infections. Clinical Infectious Diseases 37, 1298–303.[CrossRef][Web of Science][Medline]
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Jones, R. N., Deshpande, L. M., Mutnick, A. H. et al. (2002). In vitro evaluation of BAL9141, a novel parenteral cephalosporin active against oxacillin-resistant staphylococci. Journal of Antimicrobial Chemotherapy 50, 915–32.
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