scholarly journals A Randomized Study Evaluating Oral Fusidic Acid (CEM-102) in Combination With Oral Rifampin Compared With Standard-of-Care Antibiotics for Treatment of Prosthetic Joint Infections: A Newly Identified Drug–Drug Interaction

2016 ◽  
Vol 63 (12) ◽  
pp. 1599-1604 ◽  
Author(s):  
Richard Pushkin ◽  
Maria D. Iglesias-Ussel ◽  
Kara Keedy ◽  
Chris MacLauchlin ◽  
Diane R. Mould ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Fusidic Acid ◽  
Randomized Study ◽  
Standard Of Care ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Drug Drug Interaction

scholarly journals Non-Candida Fungal Prosthetic Joint Infections

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1410
Author(s):  
Christos Koutserimpas ◽  
Ifigeneia Chamakioti ◽  
Stylianos Zervakis ◽  
Konstantinos Raptis ◽  
Kalliopi Alpantaki ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Revision Arthroplasty ◽  
Standard Of Care ◽  
Surgical Interventions ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
The Mean ◽  
Mean Time

Background: Fungal prosthetic joint infections (PJIs) are rare, especially those caused by non-Candida species. Treatment has not been fully elucidated, since a plethora of antifungal and surgical interventions have been proposed. Τhis study represents an effort to clarify the optimal management of non-Candida fungal PJIs, by reviewing all relevant published cases. Methods: A thorough review of all existing non-Candida fungal PJIs in the literature was conducted. Data regarding demographics, responsible organisms, antifungal treatment (AFT), surgical intervention, time between initial arthroplasty and onset of symptoms, and time between onset of symptoms and firm diagnosis, as well as the infection’s outcome, were evaluated. Results: Forty-two PJIs, in patients with mean age of 66.2 years, were found and reviewed. Aspergillus spp. were isolated in most cases (10; 23.8%), followed by Coccidioides spp. (7; 16.7%) and Pichiaanomala (5; 11.9%). Fluconazole was the preferred antifungal regimen (20 cases; 47.6%), followed by amphotericin B (18 cases; 42.9%), while the mean AFT duration was 9.4 months (SD = 7.06). Two-stage revision arthroplasty (TSRA) was performed in 22 cases (52.4%), with the mean time between stages being 5.2 months (SD = 2.9). The mean time between initial joint implantation and onset of symptoms was 42.1 months (SD = 50.7), while the mean time between onset of symptoms and diagnosis was 5.8 months (SD = 14.3). Conclusions: Non-Candida fungal PJIs pose a clinical challenge, demanding a multidisciplinary approach. The present review has shown that combination of TSRA separated by a 3–6-month interval and prolonged AFT has been the standard of care in the studied cases.

scholarly journals In VitroActivity of CEM-102 (Fusidic Acid) against Prevalent Clones and Resistant Phenotypes of Staphylococcus aureus

2013 ◽  
Vol 57 (9) ◽  
pp. 4535-4536 ◽  
Author(s):  
D. F. Sahm ◽  
J. Deane ◽  
C. M. Pillar ◽  
P. Fernandes
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Fusidic Acid ◽  
Oral Treatment ◽  
The United States ◽  
Content Type ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

ABSTRACTClinical development of CEM-102 (fusidic acid) has recently begun in the United States for chronic oral treatment of prosthetic joint infections. To support this development, thein vitroactivity of fusidic acid against importantStaphylococcus aureusclones and resistance phenotypes was determined. Against 51 such isolates, the modal fusidic acid MIC was 0.12 μg/ml (range, 0.06 to 0.25 μg/ml for 49 isolates). This level ofin vitrofusidic acid activity underscores the potential clinical utility of this compound in the United States.

scholarly journals Outcome of Debridement and Retention in Prosthetic Joint Infections by Methicillin-Resistant Staphylococci, with Special Reference to Rifampin and Fusidic Acid Combination Therapy

2012 ◽  
Vol 57 (1) ◽  
pp. 350-355 ◽  
Author(s):  
T. N. Peel ◽  
K. L. Buising ◽  
M. M. Dowsey ◽  
C. A. Aboltins ◽  
J. R. Daffy ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Fusidic Acid ◽  
Treatment Success ◽  
Treatment Modalities ◽  
Methicillin Resistant ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

ABSTRACTThe management of prosthetic joint infections remains a clinical challenge, particularly infections due to methicillin-resistant staphylococci. Previously, this infection was considered a contraindication to debridement and retention strategies. This retrospective cohort study examined the treatment and outcomes of patients with arthroplasty infection by methicillin-resistant staphylococci managed by debridement and retention in conjunction with rifampin-fusidic acid combination therapy. Over an 11-year period, there were 43 patients with infection by methicillin-resistant staphylococci managed with debridement and retention. This consisted of close-interval repeated arthrotomies with pulsatile lavage. Rifampin was combined with fusidic acid for the majority of patients (88%). Patients were monitored for a median of 33.5 months (interquartile range, 20 to 54 months). Overall, 9 patients experienced treatment failure, with 12- and 24-month estimates of infection-free survival of 86% (95% confidence interval [CI], 71 to 93%) and 77% (95% CI, 60 to 87%), respectively. The following factors were associated with treatment failure: methicillin-resistantStaphylococcus aureus(MRSA) arthroplasty infection, a single surgical debridement or ≥4 debridements, and the receipt of less than 90 days of antibiotic therapy. Patients with infection by methicillin-resistant coagulase-negative staphylococci (MR-CNS) were less likely to fail treatment. The overall treatment success rate reported in this study is comparable to those of other treatment modalities for prosthetic joint infections by methicillin-resistant staphylococci. Therefore, the debridement and retention of the prosthesis and rifampin-based antibiotic therapy are a valid treatment option for carefully selected patients.

scholarly journals Genomic Analysis of Cutibacterium acnes Strains Isolated from Prosthetic Joint Infections

2021 ◽  
Vol 9 (7) ◽  
pp. 1500
Author(s):  
Llanos Salar-Vidal ◽  
Yvonne Achermann ◽  
John-Jairo Aguilera-Correa ◽  
Anja Poehlein ◽  
Jaime Esteban ◽  
...  
Keyword(s):  
Normal Skin ◽  
Genomic Analysis ◽  
Healthy Skin ◽  
Common Cause ◽  
Good Outcome ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes ◽  
Clinical Conditions

Cutibacterium acnes is a common cause of prosthetic joint infections (PJIs). The C. acnes population can be divided into six main phylotypes (IA1, IA2, IB, IC, II and III) that are associated with different clinical conditions and normal skin. A single-locus sequence typing (SLST) scheme can distinguish ten main SLST types: A-E (all IA1), F (IA2), G (IC), H (IB), K (II), L (III). We genome-sequenced and compared 16 strains of C. acnes isolated from healthy skin (n = 4) and PJIs (n = 12), including six PJI cases with a good outcome (four shoulder PJIs, one hip PJI, one knee PJI) and six with infection relapse (three shoulder PJIs, three hip PJIs). The sequenced strains belonged to four different phylotypes (IA1, IA2, IB and II) and seven different SLST types. All five type IB strains (all SLST type H1) were PJI isolates (three hip PJIs, two shoulder PJIs), and four of these caused infection relapse (three hip PJIs, one shoulder PJI). Isolates from PJI cases with a good outcome belonged to three different phylotypes (IA, IB, II). Interestingly, four strains (three strains from PJI cases with good outcome and one strain from healthy skin) contained a linear plasmid; these strains belonged to different SLST types (A1, C1, F4, H1) and were isolated in three different hospitals. This study suggests that type IB strains have the potential to cause infection relapse, in particular regarding hip PJIs. Moreover, our study revealed that strains belonging to the same SLST type can differ in their accessory genome in different geographic locations, indicative of microevolution.

scholarly journals Long-Term Use of Tedizolid in Osteoarticular Infections: Benefits among Oxazolidinone Drugs

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 53
Author(s):  
Eva Benavent ◽  
Laura Morata ◽  
Francesc Escrihuela-Vidal ◽  
Esteban Alberto Reynaga ◽  
Laura Soldevila ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Joint Infection ◽  
Diabetic Foot Infections ◽  
Osteoarticular Infections ◽  
Prosthetic Joint ◽  
Implant Retention ◽  
Lower Drug ◽  
Drug Drug Interaction ◽  
Staphylococcus Spp

Background: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. Methods: Multicentric retrospective study (January 2017–March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. Results: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15–44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. Conclusions: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.

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