6/29/23, 1:13 AM Rifampin in staphylococcal PJIs Pathway Feedback Search Clinical Topics Home Studies Rifampin in staphylococcal PJIs Rifampin in staphylococcal PJIs Disease Disease Prosthetic joint infection Septic arthritis Trial question What is the role of rifampin combination therapy in acute staphylococcal prosthetic joint infection treated with debridement and retention of the implant? Study design Multi-center Open label RCT Population Characteristics of study participants 33.3% female N = 99 66.7% male 99 patients (16 female, 32 male) Inclusion criteria: patients with prosthetic joint infection after hip and knee arthroplasties Key exclusion criteria: prosthetic joint infection with other bacteria than staphylococci, expected survival < 2 years, inability to comply with treatment and/or follow-up visits, and contraindications to the use of rifampin, cloxacillin, or vancomycin Interventions N=23 rifampin combination therapy (rifampin plus cloxacillin in methicillin-susceptible S. aureus or rifampin plus vancomycin in methicillin-resistant S. epidermidis for 6 weeks) N=25 monotherapy (cloxacillin in methicillin-susceptible staphylococci and vancomycin in methicillin-resistant S. epidermidis for 6 weeks) https://web.pathway.md/studies/recycPIuSVVZawDb4 1/2 6/29/23, 1:13 AM Rifampin in staphylococcal PJIs Pathway Primary outcome Rate of no signs of infection after 2 years of follow-up 74.0 % 74 72 55.5 % 37.0 % 18.5 % No significant difference 0.0 % Rifampin combination therapy Monotherapy No significant difference in the rate of no signs of infection after 2 years of follow-up (74% vs. 72%; RR 1.03, 95% CI 0.73 to 1.45) Secondary outcomes No significant difference in cure rate for S. aureus infection (77.8% vs. 65%; RR 1.2, 95% CI 0.8 to 1.8) No significant difference in cure rate for coagulase-negative Staphylococci (60% vs. 100%; RR 0.6, 95% CI 0.29 to 1.22) Safety outcomes No significant difference in discontinuation of rifampin or vancomycin due to side-effects. Significant difference in increased serum-creatinine levels for rifampin and vancomycin (0% vs. 65%). Conclusion In patients with prosthetic joint infection after hip and knee arthroplasties, rifampin combination therapy was not superior to monotherapy with respect to the rate of no signs of infection after 2 years of follow-up. Reference ystein Espeland Karlsen, P l Borgen, Bj rn Bragnes et al. Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial. J Orthop Surg Res. 2020 Aug 28;15(1):365. Open reference URL https://web.pathway.md/studies/recycPIuSVVZawDb4 2/2