Clinical experience with daptomycin for the treatment of patients with knee and hip periprosthetic joint infections

Corona, Pablo S.; Ojeda, Victor Barro; Rodríguez-Pardo, Dolors; Serrallach, C. Pigrau; Farfán, Ernesto Guerra; Amat, Carles; Sánchez, Xavier

doi:10.1093/jac/dks119

Cited by 45 publications

(37 citation statements)

References 26 publications

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“…We defined treatment failure [9] as the need for subsequent infection-related surgery for persistence or relapse of the infection, the need for prolonged suppressive antibiotic treatment, or the presence of infection symptoms observed at the outpatient followup.…”

Section: Followup Outpatient Protocolmentioning

confidence: 99%

Industrially Prefabricated Cement Spacers: Do Vancomycin- and Gentamicin-impregnated Spacers Offer Any Advantage?

Corona

Barro

Mendez

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Industrially preformed antibiotic-loaded cement spacers are useful to facilitate the second stage of two-stage exchange arthroplasty for infected THAs and TKAs. However, whether gentamicin alone or a combination of antibiotics (such as vancomycin and gentamicin) is more effective is not known. Questions/purposesWe therefore sought to compare industrially prefabricated spacers containing either gentamicin or gentamicin and vancomycin with respect to (1) infection control, (2) complications, and (3) quality of life, pain, and patient satisfaction. Methods We performed a review of 51 patients with chronic infections treated at one center using either gentamicin or vancomycin and gentamicin-prefabricated spacers. The former were used exclusively from January 2006 until May 2009, and the latter from June 2009 until July 2011, and there was no overlap. We collected data on demographics, immunologic status (McPherson classification), prosthetic joint infection location, type of prosthesis, microbiologic results, and time between stages. We evaluated the primary outcome of infection control or recurrence after at least 12 months followup. We also recorded complications. Each patient completed a qualityof-life survey, VAS, and a self-administered satisfaction scale. Results The overall infection control rate was 83% after a mean followup of 35 months (range, 12.4-64.7 months). There were no differences between gentamicin and vancomycin and gentamicin spacers in terms of infection eradication (80 % versus 85 %, respectively; p = 0.73), nor in terms of complications, quality of life, pain, or satisfaction scores. Conclusions Prefabricated, antibiotic-loaded cement spacers has been proven effective for infection control in TKAs and THAs but with the numbers available, we did not find any differences between a gentamicin or vancomycin and gentamicin-prefabricated spacer, and therefore, we are unable to validate the superiority of the combination of vancomycin and gentamicin over gentamicin alone. Because of the higher costs involved with vancomycin and gentamicin spacers, and the potential risks of unselective use of

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Section: Followup Outpatient Protocolmentioning

confidence: 99%

Industrially Prefabricated Cement Spacers: Do Vancomycin- and Gentamicin-impregnated Spacers Offer Any Advantage?

Corona

Barro

Mendez

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Recent studies indicate a growing interest in the design of novel therapeutic protocols for deep-seated multi-resistant Gram-positive infections, as alternatives to the standard glycopeptide therapy [2][3][4][5][6][7][8]. Daptomycin has attractive properties for treating osteoarticular infections, because of its rapid bactericidal activity against susceptible as well as multi-resistant, Gram-positive isolates.…”

Section: Discussionmentioning

confidence: 99%

“…Emergence of daptomycin resistance remains a rare event in staphylococci and is limited to individual case reports [9,10]. While recent clinical data assessed the efficacy and safety of high-dose daptomycin in Gram-positive osteoarticular infections [2][3][4][5][6], no specific study evaluated the combined regimen of high-dose daptomycin (8 mg/kg/day) and rifampicin (600 mg/day) in this context. In view of the quite variable (from 300 to 1,200 mg/day) regimens of rifampicin that have been described in the literature, official recommendations for a standard rifampicin regimen in the context of osteoarticular infections would be most appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…This study also reported that concomitant administration of daptomycin and statins was safe and not associated with an increased risk of rhabdomyolysis or myositis. In another retrospective study, Corona Perez-Cardona et al described 20 patients with knee or hip periprosthetic joint infections, who received an average daptomycin dose of 6.6 mg/kg/day for a mean duration of 44.9 days [3]. Only 14 of those patients were evaluable for outcome, yielding an overall success rate of 78.6 %.…”

Section: Discussionmentioning

confidence: 99%

“…Very few antimicrobial agents remain available for therapy of osteoarticular infections that are due to multi-resistant Gram-positive pathogens, in particular methicillin-resistant S. aureus (MRSA). Besides glycopeptides that remain the mainstay for therapy of MRSA deep-seated infections, some recently developed agents that are active against both susceptible and multi-resistant, gram-positive pathogens including MRSA, in particular daptomycin [2][3][4][5][6] and linezolid [7,8], have been recently evaluated for therapy of osteoarticular infections.…”

Section: Introductionmentioning

confidence: 99%

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The safety and efficacy of high-dose daptomycin combined with rifampicin for the treatment of Gram-positive osteoarticular infections

Jugun

Vaudaux

Garbino

et al. 2013

International Orthopaedics (SICOT)

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Purpose Treatment of Gram-positive osteoarticular infections requires an adequate surgical approach combined with intensive antimicrobial therapy. The aim of this study was to evaluate the safety and efficacy of a combined regimen of high-dose daptomycin and rifampicin, in patients with various types of Gram-positive osteoarticular infections. Methods This single centre, non-comparative, prospective study evaluated the safety and efficacy of a combined regimen of intravenous daptomycin (8 mg/kg/day) and oral rifampicin (600 mg/day) in patients with Gram-positive osteoarticular infections, with a minimal follow-up of one year. Creatine phosphokinase, transaminases, bilirubinaemia, and serum creatinine, were measured at baseline and regular intervals. Results The median daily doses of daptomycin and rifampicin, administered for a median duration of 21 (range, 10-122) days to 16 patients (median age, 63.5 years; 11 males, five females) presenting with staphylococcal (n=15) or streptococcal (n=1) osteoarticular infections, were 8.15 (range, 6.6-8.9) mg/kg/day and 600 (range, 600-900) mg/day, respectively. The combined regimen of daptomycin and rifampicin was well tolerated by all except one patient, without requiring treatment adjustment or discontinuation. One patient developed allergic responses probably due to rifampicin after 42 days. Fifteen (94 %) patients showed favourable clinical and microbiological outcomes. Conclusions The combined regimen of high-dose daptomycin and rifampicin was well tolerated and may provide a useful alternative to standard glycopeptide therapy for Gram-positive osteoarticular infections.

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Incidence, Complications and Novel Treatment Strategies: Joint Arthroplasty

Simpson

2022

Musculoskeletal Infection

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Clinical experience with daptomycin for the treatment of patients with knee and hip periprosthetic joint infections

Abstract: The combination of high daptomycin doses with an adequate surgical approach could be a viable alternative in cases of difficult-to-treat Gram-positive PJIs. Due to the risk of potentially serious adverse events, serum CPK level should be closely monitored.

Cited by 45 publications

References 26 publications

Industrially Prefabricated Cement Spacers: Do Vancomycin- and Gentamicin-impregnated Spacers Offer Any Advantage?

Industrially Prefabricated Cement Spacers: Do Vancomycin- and Gentamicin-impregnated Spacers Offer Any Advantage?

The safety and efficacy of high-dose daptomycin combined with rifampicin for the treatment of Gram-positive osteoarticular infections

Incidence, Complications and Novel Treatment Strategies: Joint Arthroplasty

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