PMID- 37998762
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231126
IS  - 2079-6382 (Print)
IS  - 2079-6382 (Electronic)
IS  - 2079-6382 (Linking)
VI  - 12
IP  - 11
DP  - 2023 Oct 24
TI  - Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic 
      Joint Infections-A Prospective Study with a Special Focus on Rifampin.
LID - 10.3390/antibiotics12111560 [doi]
LID - 1560
AB  - Periprosthetic Joint Infection (PJI) is a significant contributor to patient 
      morbidity and mortality, and it can be addressed through a range of surgical 
      interventions coupled with antibiotic therapies. Following surgical 
      intervention(s), prolonged administration of oral antibiotics is recommended to 
      cure PJI. There is a lack of reports on the adverse events (AEs) associated with 
      oral antibiotics, particularly rifampin. This investigation sought to elucidate 
      the occurrence of antibiotic-related AEs after an initial regimen of intravenous 
      antibiotic administration, supplemented by an extended course of oral 
      antibiotics. A prospective study of patients diagnosed with PJI of the hip, knee, 
      or shoulder who underwent single-stage exchange arthroplasty (SSE) (10%), 
      two-stage exchange arthroplasty (TSE) (81%), or debridement, antibiotics, and 
      implant retention (DAIR) (6%) was performed. The primary outcome of interest was 
      the detection of AEs, the secondary outcome the detection of a correlation 
      between rifampin use and the incidence of AEs, and the tertiary outcome was 
      whether oral antibiotic treatment needed to be adjusted or discontinued due to 
      AEs. In addition, subjective tolerability was monitored throughout the study. A 
      total of 336 events were identified for 73 out of 80 patients. The most 
      frequently used antibiotics were rifampin and co-trimoxazole. Most AEs occurred 
      in the gastrointestinal tract (46%). The most frequent AEs were nausea, 
      inappetence, diarrhea, and skin rash. In 6% of cases, the AEs led to antibiotic 
      discontinuation, and in 29% of cases, a dose adjustment of the oral therapy 
      occurred, mainly with amoxicillin or co-trimoxazole. The majority of patients 
      (55%) rated the subjective tolerability as good. In conclusion, AEs during 
      antibiotic treatment for PJI are common. They mainly affect the gastrointestinal 
      tract. Rifampin use might be a reason for the higher incidence of AEs compared to 
      non-rifampin antibiotic treatment.
FAU - Reinecke, Pia
AU  - Reinecke P
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Morovic, Paula
AU  - Morovic P
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Niemann, Marcel
AU  - Niemann M
AUID- ORCID: 0000-0001-7264-3089
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Renz, Nora
AU  - Renz N
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Perka, Carsten
AU  - Perka C
AUID- ORCID: 0000-0002-0993-581X
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Trampuz, Andrej
AU  - Trampuz A
AUID- ORCID: 0000-0002-5219-2521
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
FAU - Meller, Sebastian
AU  - Meller S
AD  - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, 
      Humboldt-Universitat zu Berlin and Berlin Institute of Health, Center for 
      Musculoskeletal Surgery (CMSC), Augustenburger Platz 1, 13353 Berlin, Germany.
LA  - eng
PT  - Journal Article
DEP - 20231024
PL  - Switzerland
TA  - Antibiotics (Basel)
JT  - Antibiotics (Basel, Switzerland)
JID - 101637404
PMC - PMC10668752
OTO - NOTNLM
OT  - adverse events
OT  - antibiotics
OT  - arthroplasty
OT  - long-term antibiotic therapy
OT  - periprosthetic joint infection
OT  - rifampin
COIS- The authors declare no conflict of interest.
EDAT- 2023/11/24 12:43
MHDA- 2023/11/24 12:44
PMCR- 2023/10/24
CRDT- 2023/11/24 09:38
PHST- 2023/10/03 00:00 [received]
PHST- 2023/10/17 00:00 [revised]
PHST- 2023/10/21 00:00 [accepted]
PHST- 2023/11/24 12:44 [medline]
PHST- 2023/11/24 12:43 [pubmed]
PHST- 2023/11/24 09:38 [entrez]
PHST- 2023/10/24 00:00 [pmc-release]
AID - antibiotics12111560 [pii]
AID - antibiotics-12-01560 [pii]
AID - 10.3390/antibiotics12111560 [doi]
PST - epublish
SO  - Antibiotics (Basel). 2023 Oct 24;12(11):1560. doi: 10.3390/antibiotics12111560.