Efficacy of a combined oral clindamycin?rifampicin regimen for therapy of staphylococcal osteoarticular infections

Article Article scientifique Article Efficacy of a combined oral clindamycin?rifampicin regimen for therapy of staphylococcal osteoarticular infections eng 2011 author Czekaj Jaroslaw 560148 author Dinh Aurélien author Moldovan Andréea Anamaria 707943 author Vaudaux Pierre 24012 author Gras Guillaume author Hoffmeyer Pierre 29797 author Lew Daniel Pablo 26516 author Bernard Louis 565251 author Uckay Ilker 134868 962-967 10.3109/00365548.2011.608082 21916775 0036-5548 A majority of osteoarticular and implant-related infections are due to staphylococci and biofilm formation. Combined therapy including rifampicin is frequently recommended. Indeed, rifampicin penetrates biofilms and kills adherent staphylococci, but cannot be administered as monotherapy because of the rapid emergence of resistant mutants. While several antibiotic combinations including rifampicin have been implemented, evaluation of the clindamycin-rifampicin combination has been neglected, presumably because of the emergence of alternative combinations, such as quinolone-rifampicin, and the fear of potential antagonistic interactions. We report a limited series of 20 patients (3 immune-suppressed) with 6 arthroplasty infections, 4 other implant infections, 7 native arthritis, and 3 osteomyelitis, who were all successfully treated with this oral combination for >75% of the antibiotic course (median duration 45 days). The excellent outcomes obtained with this antimicrobial combination after a mean follow-up of 2.6 y (range 1.0-6.1 y) warrant further clinical and microbiological studies for implementing this regimen in routine practice. Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents/administration & dosage Clindamycin/administration & dosage Drug Therapy, Combination/methods Female Humans Male Middle Aged Osteoarthritis/drug therapy/microbiology Prosthesis-Related Infections/drug therapy/microbiology Rifampin/administration & dosage Staphylococcal Infections/drug therapy Staphylococcus/drug effects Treatment Outcome Young Adult Dewey 616 Dewey 617 56 Département de médecine 221 57 Département de chirurgie 222 false 74 Chirurgie orthopédique et traumatologique 98 526 Résistance aux antibiotiques 866 19 Glycopeptide résistance 28 Scandinavian journal of infectious diseases 43 11-12 4d898c42-cb5e-4bb1-b423-b91f721d0023 Article (Published version) Restricted 2011_czekaj_scand_j_infect_dis.pdf 105511 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Efficacy of a combined oral clindamycin?rifampicin regimen for therapy of staphylococcal osteoarticular infections	Scandinavian journal of infectious diseases			2011	714	3

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Czekaj, Jaroslaw