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Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin

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 t...

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Autores principales: Reinecke, Pia, Morovic, Paula, Niemann, Marcel, Renz, Nora, Perka, Carsten, Trampuz, Andrej, Meller, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668752/
https://www.ncbi.nlm.nih.gov/pubmed/37998762
http://dx.doi.org/10.3390/antibiotics12111560
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author Reinecke, Pia
Morovic, Paula
Niemann, Marcel
Renz, Nora
Perka, Carsten
Trampuz, Andrej
Meller, Sebastian
author_facet Reinecke, Pia
Morovic, Paula
Niemann, Marcel
Renz, Nora
Perka, Carsten
Trampuz, Andrej
Meller, Sebastian
author_sort Reinecke, Pia
collection PubMed
description 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.
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spelling pubmed-106687522023-10-24 Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin Reinecke, Pia Morovic, Paula Niemann, Marcel Renz, Nora Perka, Carsten Trampuz, Andrej Meller, Sebastian Antibiotics (Basel) Article 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. MDPI 2023-10-24 /pmc/articles/PMC10668752/ /pubmed/37998762 http://dx.doi.org/10.3390/antibiotics12111560 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Reinecke, Pia
Morovic, Paula
Niemann, Marcel
Renz, Nora
Perka, Carsten
Trampuz, Andrej
Meller, Sebastian
Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title_full Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title_fullStr Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title_full_unstemmed Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title_short Adverse Events Associated with Prolonged Antibiotic Therapy for Periprosthetic Joint Infections—A Prospective Study with a Special Focus on Rifampin
title_sort adverse events associated with prolonged antibiotic therapy for periprosthetic joint infections—a prospective study with a special focus on rifampin
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668752/
https://www.ncbi.nlm.nih.gov/pubmed/37998762
http://dx.doi.org/10.3390/antibiotics12111560
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