Suppressive antibiotic therapy with oral doxycycline for Staphylococcus aureus prosthetic joint infection: a retrospective study of 39 patients

Pradier, M.; Nguyen, S.; Robineau, Olivier; Titécat, Marie; Blondiaux, Nicolas; Valette, M.; Loïez, Caroline; Beltrand, E.; Dezèque, Hervé; Migaud, Henri; Senneville, Éric

doi:10.1016/j.ijantimicag.2017.04.019

Cited by 24 publications

(16 citation statements)

References 30 publications

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“…This antibiotic has previously been shown to be highly effective against a panel of MRSA clinical isolate biofilms . Recently, suppressive doxycycline therapy in a small and high risk PJI cohort showed reasonable effectiveness and tolerability of the antibiotic for successful treatment . To our knowledge, our work is the first‐time doxycycline has been demonstrated to be as effective as rifampin or daptomycin at killing S. aureus mature biofilms from PJI patients.…”

Section: Discussionmentioning

confidence: 73%

Large variations in clinical antibiotic activity against Staphylococcus aureus biofilms of periprosthetic joint infection isolates

Mandell

Orr

Koch

et al. 2019

Journal Orthopaedic Research

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Staphylococcus aureus biofilms have a high tolerance to antibiotics, making the treatment of periprosthetic joint infection (PJI) challenging. From a clinical perspective, bacteria from surgical specimens are cultured in a planktonic state to determine antibiotic sensitivity. However, S. aureus exists primarily as established biofilms in PJI. To address this dichotomy, we developed a prospective registry of total knee and hip arthroplasty PJI S. aureus isolates to quantify the activity of clinically important antibiotics against isolates grown as biofilms. S. aureus planktonic minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were assessed using clinical laboratory standard index assays for 10 antibiotics (cefazolin, clindamycin, vancomycin, rifampin, linezolid, nafcillin, gentamicin, trimethoprim/sulfamethoxazole, doxycycline, and daptomycin). Mature biofilms of each strain were grown in vitro, after which biofilm MIC (MBIC) and biofilm MBC (MBBC) were determined. Overall, isolates grown as biofilms displayed larger variations in antibiotic MICs as compared to planktonic MIC values. Only rifampin, doxycycline, and daptomycin had measurable biofilm MIC values across all S. aureus isolates tested. Biofilm MBC observations complemented biofilm MIC observations; rifampin, doxycycline, and daptomycin were the only antibiotics with measurable biofilm MBC values. 90% of S. aureus biofilms could be killed by rifampin, 50% by doxycycline, and only 15% by daptomycin. Biofilm formation increased bacterial antibiotic tolerance nonspecifically across all antibiotics, in both MSSA and MRSA samples. Rifampin and doxycycline were the most effective antibiotics at killing established S. aureus biofilms. ß

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Section: Discussionmentioning

confidence: 73%

Large variations in clinical antibiotic activity against Staphylococcus aureus biofilms of periprosthetic joint infection isolates

Mandell

Orr

Koch

et al. 2019

Journal Orthopaedic Research

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“…18 Fluoroquinolones may cause permanent skin hyperpigmentation and hepatotoxicity though these side effects are less common with doxycycline. 32,33…”

Section: Side Effectsmentioning

confidence: 99%

“…When used alone, this has a low likelihood of infection eradication and is often used as a "salvage" therapy, a last-resort effort to retain the functional implant. 32 Sometimes, SAT is necessary for PJI patients who are unable to undergo surgical revision due to poor bone quality such as osteopenia or have other severe medical comorbidities, like cancer, 4 that will hinder their recovery from the infection after surgery. 32 It is also an alternative strategy for individuals who need to undergo a disabling surgery such as an arthrodesis or amputation to eradicate the PJI.…”

Section: Oral Antibiotics For Suppression Antibiotic Therapymentioning

confidence: 99%

“…32 Sometimes, SAT is necessary for PJI patients who are unable to undergo surgical revision due to poor bone quality such as osteopenia or have other severe medical comorbidities, like cancer, 4 that will hinder their recovery from the infection after surgery. 32 It is also an alternative strategy for individuals who need to undergo a disabling surgery such as an arthrodesis or amputation to eradicate the PJI. 4 Currently, there is no consensus on SAT indications, duration of treatment, or choice of antibiotic.…”

Section: Oral Antibiotics For Suppression Antibiotic Therapymentioning

confidence: 99%

“…33 SAT success rates are also difficult to compare because the antibiotic therapy regimens preceding SAT are highly variable with some patients receiving rifampin combination therapies and others receiving linezolid. 32 Many studies generally describe SAT for PJI in terms of treatment that is not broken down by antibiotic agent. 32 Multiple studies have used a variety of agents including tetracyclines, β-lactams, clindamycin, fluoroquinolones, cotrimoxazole, and rifampicin in SAT.…”

Section: Oral Antibiotics For Suppression Antibiotic Therapymentioning

confidence: 99%

See 2 more Smart Citations

Extended Oral Antibiotics and Infection Prophylaxis after a Primary or Revision Total Knee Arthroplasty

2019

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One of the most common reasons for failure of primary total knee arthroplasty and need for revision surgery is periprosthetic infection. Antibiotics are one of the mainstays of treatment to address prosthetic joint infections, but the route of administration and timing of delivery to optimize patient outcomes are debated. This article reviews the use and attributes of commonly used oral antibiotics, especially extended or long-term utilization, as prophylaxis and treatment for prosthetic joint infections in a primary or revision total knee arthroplasty, which include debridement, antibiotics, and implant retention, one-stage and two-stage exchange arthroplasty.

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Preventing Infection in Revision Shoulder Arthroplasty

Khan,

Fares,

Abboud

2023

Revision Shoulder Arthroplasty

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Suppressive antibiotic therapy with oral doxycycline for Staphylococcus aureus prosthetic joint infection: a retrospective study of 39 patients

Cited by 24 publications

References 30 publications

Large variations in clinical antibiotic activity against Staphylococcus aureus biofilms of periprosthetic joint infection isolates

Large variations in clinical antibiotic activity against Staphylococcus aureus biofilms of periprosthetic joint infection isolates

Extended Oral Antibiotics and Infection Prophylaxis after a Primary or Revision Total Knee Arthroplasty

Preventing Infection in Revision Shoulder Arthroplasty

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