Goetz, Julia and Keyssner, Verena and Hanses, Frank and Greimel, Felix and Leiss, Franziska and Schwarz, Timo and Springorum, Hans-Robert and Grifka, Joachim and Schaumburger, Jens (2022) Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA. BONE & JOINT RESEARCH, 11 (3). pp. 143-151. ISSN 2046-3758,
Full text not available from this repository. (Request a copy)Abstract
Aims Periprosthetic joint infections (PJIs) are rare, but represent a great burden for the patient. In addition, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing. The aim of this rat experiment was therefore to compare the antibiotics commonly used in the treatment of PJIs caused by MRSA. Methods For this purpose, sterilized steel implants were implanted into the femur of 77 rats. The metal devices were inoculated with suspensions of two different MRSA strains. The animals were divided into groups and treated with vancomycin, linezolid, cotrimoxazole, or rifampin as monotherapy, or with combination of antibiotics over a period of 14 days. After a two-day antibiotic-free interval, the implant was explanted, and bone, muscle, and periarticular tissue were microbiologically analyzed. Results Vancomycin and linezolid were able to significantly (p < 0.05) reduce the MRSA bacterial count at implants. No significant effect was found at the bone. Rifampin was the only monotherapy that significantly reduced the bacterial count on implant and bone. The combination with vancomycin or linezolid showed significant efficacy. Treatment with cotrimoxazole alone did not achieve a significant bacterial count reduction. The combination of linezolid plus rifampin was significantly more effective on implant and bone than the control group in both trials. Conclusion Although rifampicin is effective as a monotherapy, it should not be used because of the high rate of resistance development. Our animal experiments showed the great importance of combination antibiotic therapies. In the future, investigations with higher case numbers, varied bacterial concentrations, and changes in individual drug dosages will be necessary to be able to draw an exact comparison, possibly within a clinical trial.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RESISTANT STAPHYLOCOCCUS-AUREUS; ONCOLOGY CLASSIFICATION-SYSTEM; FOREIGN-BODY INFECTION; EXPERIMENTAL OSTEOMYELITIS; COMBINATION; MOXIFLOXACIN; DAPTOMYCIN; MRSA; Infection of the artificial joint; Combination antibiotics therapies; Antibiotics monotherapy; Vancomycin; Rifampin or cotrimoxazole; Linezolid and rifampin |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie Medicine > Abteilung für Krankenhaushygiene und Infektiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Oct 2023 14:01 |
| Last Modified: | 17 Oct 2023 14:01 |
| URI: | https://pred.uni-regensburg.de/id/eprint/56452 |
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