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. 2022 Dec 11;11(12):1801.
doi: 10.3390/antibiotics11121801.

Cutibacterium acnes Prosthetic Joint Infections: Is Rifampicin-Combination Therapy Beneficial?

Grégoire Saltiel  1   2 , Vanina Meyssonnier  1   2 , Younes Kerroumi  1 , Beate Heym  1   3 , Olivier Lidove  2 , Simon Marmor  1   4 , Valérie Zeller  1   2
Affiliations

Cutibacterium acnes Prosthetic Joint Infections: Is Rifampicin-Combination Therapy Beneficial?

Grégoire Saltiel et al. Antibiotics (Basel). .

Abstract

No consensus has been reached on the optimal antibiotic regimen to treat Cutibacterium acnes PJIs (Ca-PJIs). In vitro studies showed excellent rifampicin efficacy against biofilm-associated C. acnes infections, but clinical studies did not confirm the superiority of rifampicin-combined therapy over monotherapy. This prospective cohort study was undertaken to analyze the outcomes of 70 patients who underwent exchange arthroplasty for chronic monomicrobial Ca-PJI and were treated with rifampicin or without between 2004 and 2019. The 37 patients treated from January 2004 to August 2014 were prescribed rifampicin-combination therapy and the 33 treated from September 2014 to December 2019 received monotherapy without rifampicin. The primary endpoint was the 2-year Kaplan-Meier-estimated reinfection-free probability, including relapses and new-pathogen PJIs. The 2-year reinfection-free rate was high and not different for patients who had received rifampicin or not (89.2% vs. 93.8%, respectively; p = 0.524). None of the patients relapsed and six developed new-pathogen PJIs. Our results do not support a benefit of rifampicin-combination therapy for patients who underwent exchange arthroplasty for chronic Ca-PJIs.

Keywords: Cutibacterium acnes; exchange arthroplasty; prosthetic joint infection; rifampicin.

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Conflict of interest statement

The authors declare no conflict of interest regarding this work.

Figures

Figure 1
Figure 1
Ca-PJIs, Cutibacterium acnes prosthetic joint infections.
Figure 2
Figure 2
Kaplan–Meier estimated reinfection (relapse or new infection)-free probabilities for the 37 rifampicin recipients and the 33 patients treated without it for chronic Ca-PJIs.
See this image and copyright information in PMC

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