PMID- 25139552 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20160404 LR - 20211021 IS - 2193-8229 (Print) IS - 2193-6382 (Electronic) IS - 2193-6382 (Linking) VI - 3 IP - 2 DP - 2014 Dec TI - A Retrospective Review of the Clinical Experience of Linezolid with or Without Rifampicin in Prosthetic Joint Infections Treated with Debridement and Implant Retention. PG - 235-43 LID - 10.1007/s40121-014-0032-z [doi] AB - INTRODUCTION: Debridement and prosthesis retention, combined with a prolonged antibiotic regimen including rifampicin, is an accepted therapeutic approach when the duration of symptoms is less than 4 weeks and there are no radiological signs of loosening. The outcome of patients managed with this strategy has been previously assessed in several articles with success rates of 60-90%. This study aims to review the clinical experience with linezolid in 3 different hospitals from Spain and France in patients with prosthetic joint infection (PJI) managed with debridement, retention of the implant and treated with linezolid with or without rifampicin. METHODS: Patients with an acute PJI who underwent open debridement with implant retention treated with linezolid for more than 7 days in 3 hospitals from Barcelona, Tours and Lille between 2005 and 2011 were retrospectively reviewed. Relevant information about demographics, co-morbidity, type of implant, surgical treatment, microorganism isolated, antimicrobial therapy, adverse events (AEs) and outcomes were recorded from patients. RESULTS: A total of 39 patients were retrospectively reviewed. The mean age (SD) was 70.5 (8.8) years and 9 patients had diabetes mellitus (23%). There were 25 (64%) knee prostheses, 13 (33%) hips and 1 shoulder (3%). The median interquartile range (IQR) days from arthroplasty to infection diagnosis was 17 (19-48) and 33 (85%) cases were diagnosed within the first 60 days. The median (IQR) duration of antibiotic treatment was 70.5 (34-96) days and the median (IQR) number of days on linezolid treatment was 44.5 (30-81). AEs were observed in 15 patients (38%), with gastrointestinal complaints in 8 cases and anemia in 5 being the most frequent. After a median (IQR) follow-up of 2.5 (1.8-3.6) years, there were 11 failures (28%) (8 relapses and 3 new infections). The failure rate was higher in the rifampicin group (36% vs. 18%) mainly due to a higher relapse rate (27% vs. 12%) although differences were not statistically significant. CONCLUSION: Management of acute PJIs with debridement and retention of the implant linezolid, with or without rifampicin, is associated with a high remission rate and it is an alternative treatment for infections due to fluoroquinolone and/or rifampicin-resistant staphylococci. FAU - Morata, Laura AU - Morata L AD - Bone and Joint Infection Unit, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain. lmorata@clinic.ub.es. FAU - Senneville, Eric AU - Senneville E AD - Lille-Tourcoing French Referent Center for Osteo-articular Infection, Lille University Hospital, Lille, France. FAU - Bernard, Louis AU - Bernard L AD - Infectious Diseases Unit, Tours University Hospital, Tours Cedex, France. FAU - Nguyen, Sophie AU - Nguyen S AD - Lille-Tourcoing French Referent Center for Osteo-articular Infection, Lille University Hospital, Lille, France. FAU - Buzele, Rodolphe AU - Buzele R AD - Infectious Diseases Unit, Tours University Hospital, Tours Cedex, France. FAU - Druon, Jerome AU - Druon J AD - Regional French Referent Center for Osteo-articular Infection, Tours Cedex, France. FAU - Tornero, Eduard AU - Tornero E AD - Bone and Joint Infection Unit, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain. FAU - Mensa, Josep AU - Mensa J AD - Bone and Joint Infection Unit, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain. FAU - Soriano, Alex AU - Soriano A AD - Bone and Joint Infection Unit, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain. LA - eng PT - Journal Article DEP - 20140820 PL - New Zealand TA - Infect Dis Ther JT - Infectious diseases and therapy JID - 101634499 PMC - PMC4269635 OTO - NOTNLM OT - Debridement OT - Infectious diseases OT - Linezolid OT - Prosthetic joint infection OT - Rifampicin OT - Treatment outcome EDAT- 2014/08/21 06:00 MHDA- 2014/08/21 06:01 PMCR- 2014/08/20 CRDT- 2014/08/21 06:00 PHST- 2014/06/18 00:00 [received] PHST- 2014/08/21 06:00 [entrez] PHST- 2014/08/21 06:00 [pubmed] PHST- 2014/08/21 06:01 [medline] PHST- 2014/08/20 00:00 [pmc-release] AID - 10.1007/s40121-014-0032-z [pii] AID - 32 [pii] AID - 10.1007/s40121-014-0032-z [doi] PST - ppublish SO - Infect Dis Ther. 2014 Dec;3(2):235-43. doi: 10.1007/s40121-014-0032-z. Epub 2014 Aug 20.