PMID- 23231054
OWN - NLM
STAT- MEDLINE
DCOM- 20130722
LR  - 20131121
IS  - 1469-0691 (Electronic)
IS  - 1198-743X (Linking)
VI  - 19
IP  - 2
DP  - 2013 Feb
TI  - Continuous high-dose vancomycin combination therapy for methicillin-resistant 
      staphylococcal prosthetic hip infection: a prospective cohort study.
PG  - E98-105
LID - 10.1111/1469-0691.12071 [doi]
AB  - Few data are available on treatment and outcome of methicillin-resistant (MR) 
      staphylococcal prosthetic joint infections. Vancomycin remains the treatment of 
      choice for these infections, but its efficacy and safety in bone-and-joint 
      infections are insufficiently documented. We conducted a prospective cohort study 
      on 60 patients treated between November 2002 and December 2008 for chronic MR 
      staphylococcal (44 S. epidermidis, nine other coagulase-negative Staphylococcus 
      and seven S. aureus) prosthetic hip infections (PHIs). Twenty-two patients had 
      previously undergone surgery for their PHI and 21 had previously received 
      antibiotics. All patients had surgery (exchange arthroplasty for 58 patients, 
      resection arthroplasty for two) and received an antibiotic regimen combining 
      high-dose continuous intravenous vancomycin infusion (target serum concentration 
      30-40 mg/L) with another antibiotic for 6 weeks, followed by an additional 6 
      weeks of oral intake. Two years after surgery, infection was considered cured in 
      41 (68%) patients and only two relapses occurred after one-stage exchange 
      arthroplasty. Nineteen (32%) patients experienced nephrotoxicity that was 
      generally mild (RIFLE class R for 14 patients, class I for four patients and 
      class F for one patient) and most often reversible. Continuous high-dose 
      intravenous vancomycin combination therapy is an effective, feasible and 
      reasonably safe treatment of chronic MR staphylococcal PHI.
CI  - (c) 2012 The Authors Clinical Microbiology and Infection (c) 2012 European Society of 
      Clinical Microbiology and Infectious Diseases.
FAU - Dubee, V
AU  - Dubee V
AD  - Service de Medecine Interne et Rhumatologie, Groupe Hospitalier Saint-Joseph, 
      Paris, France.
FAU - Zeller, V
AU  - Zeller V
FAU - Lhotellier, L
AU  - Lhotellier L
FAU - Kitzis, M-D
AU  - Kitzis MD
FAU - Ziza, J-M
AU  - Ziza JM
FAU - Mamoudy, P
AU  - Mamoudy P
FAU - Desplaces, N
AU  - Desplaces N
LA  - eng
PT  - Journal Article
DEP - 20121210
PL  - England
TA  - Clin Microbiol Infect
JT  - Clinical microbiology and infection : the official publication of the European 
      Society of Clinical Microbiology and Infectious Diseases
JID - 9516420
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*administration & dosage
MH  - Arthroplasty
MH  - Cohort Studies
MH  - Debridement
MH  - Drug Therapy, Combination/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - *Methicillin Resistance
MH  - Middle Aged
MH  - Osteoarthritis/*drug therapy/microbiology/surgery
MH  - Prospective Studies
MH  - Prosthesis-Related Infections/*drug therapy/microbiology/surgery
MH  - Staphylococcal Infections/*drug therapy/microbiology/surgery
MH  - Staphylococcus/classification/drug effects/*isolation & purification
MH  - Treatment Outcome
MH  - Vancomycin/*administration & dosage
EDAT- 2012/12/13 06:00
MHDA- 2013/07/23 06:00
CRDT- 2012/12/13 06:00
PHST- 2012/09/14 00:00 [received]
PHST- 2012/09/07 00:00 [revised]
PHST- 2012/10/10 00:00 [accepted]
PHST- 2012/12/13 06:00 [entrez]
PHST- 2012/12/13 06:00 [pubmed]
PHST- 2013/07/23 06:00 [medline]
AID - S1198-743X(14)60261-5 [pii]
AID - 10.1111/1469-0691.12071 [doi]
PST - ppublish
SO  - Clin Microbiol Infect. 2013 Feb;19(2):E98-105. doi: 10.1111/1469-0691.12071. Epub 
      2012 Dec 10.