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

Dinh, Aurélien
Gras, Guillaume
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Published in Scandinavian Journal of Infectious Diseases. 2011, vol. 43, no. 11-12, p. 962-7
Abstract 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.
Keywords AdolescentAdultAgedAged, 80 and overAnti-Bacterial Agents/administration & dosageClindamycin/administration & dosageDrug Therapy, Combination/methodsFemaleHumansMaleMiddle AgedOsteoarthritis/drug therapy/microbiologyProsthesis-Related Infections/drug therapy/microbiologyRifampin/administration & dosageStaphylococcal Infections/drug therapyStaphylococcus/drug effectsTreatment OutcomeYoung Adult
PMID: 21916775
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Research groups Chirurgie orthopédique et traumatologique (98)
Glycopeptide résistance (28)
Groupe Harbarth Stephan (Staphylocoques dorés résistants à la méthicilline) (866)
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CZEKAJ, Jaroslaw et al. Efficacy of a combined oral clindamycin?rifampicin regimen for therapy of staphylococcal osteoarticular infections. In: Scandinavian Journal of Infectious Diseases, 2011, vol. 43, n° 11-12, p. 962-7. doi: 10.3109/00365548.2011.608082 https://archive-ouverte.unige.ch/unige:24818

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Deposited on : 2012-12-20

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