Florent Valour1, André Boibieux2, Judith Karsenty3, Marie-Paule Vallat2, Evelyne Braun2, Thomas Perpoint2, François Biron2, Frédéric Laurent4, Sébastien Lustig5, Christian Chidiac6, Tristan Ferry6. 1. Department of Infectious Diseases, Hospices Civils de Lyon, 103 Grande-Rue de la Croix-Rousse, 69004 Lyon, France French Regional Reference Centre for Bone and Joint Infection, Hospices Civils de Lyon, Lyon, France International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France florent.valour@chu-lyon.fr. 2. Department of Infectious Diseases, Hospices Civils de Lyon, 103 Grande-Rue de la Croix-Rousse, 69004 Lyon, France French Regional Reference Centre for Bone and Joint Infection, Hospices Civils de Lyon, Lyon, France. 3. Department of Infectious Diseases, Châlon-sur-Saône Hospital, Châlon-sur-Saône, France. 4. French Regional Reference Centre for Bone and Joint Infection, Hospices Civils de Lyon, Lyon, France International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France Laboratory of Bacteriology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France. 5. French Regional Reference Centre for Bone and Joint Infection, Hospices Civils de Lyon, Lyon, France International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France Orthopaedic Surgery Unit, Hospices Civils de Lyon, Lyon, France. 6. Department of Infectious Diseases, Hospices Civils de Lyon, 103 Grande-Rue de la Croix-Rousse, 69004 Lyon, France French Regional Reference Centre for Bone and Joint Infection, Hospices Civils de Lyon, Lyon, France International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France.
Abstract
OBJECTIVES: The aim of this study was to evaluate pristinamycin in the treatment of MSSA bone and joint infection (BJI). PATIENTS AND METHODS: A retrospective, single-centre cohort study (2001-11) investigated outcome in adults receiving pristinamycin for MSSA BJI and pristinamycin-related adverse events (AEs). RESULTS: One hundred and two MSSA BJIs were assessed in 98 patients [chronic infection, 33.3%; and orthopaedic device-related infection (ODI), 67.6%]. Surgery was performed in 77.5% of total cases, and in all but three ODIs, associated with antibiotic therapy of a median total duration of 29.2 weeks. Pristinamycin was prescribed as a part of the initial intensive treatment phase (29.4%) and/or included in final maintenance therapy (83.3%) at a dose of 47.6 (45.5-52.6) mg/kg/day for 9.3 (1.4-20.4) weeks. AEs occurred in 13.3% of patients, consisting of gastrointestinal disorder (76.9%) or allergic reaction (23.1%), leading to treatment interruption in 11 cases. AEs were related to daily dose (OR, 2.733 for each 10 additional mg/kg/day; P = 0.049). After a follow-up of 76.4 (29.6-146.9) weeks, the failure rate was 34.3%, associated with ODI (OR, 4.421; P = 0.006), particularly when the implant was retained (OR, 4.217; P = 0.007). In most patients, the pristinamycin companion drug was a fluoroquinolone (68.7%) or rifampicin (21.7%), without difference regarding outcome. CONCLUSIONS: Pristinamycin is an effective, well-tolerated alternative therapeutic option in MSSA BJI, on condition that a daily dosage of 50 mg/kg is respected.
OBJECTIVES: The aim of this study was to evaluate pristinamycin in the treatment of MSSA bone and joint infection (BJI). PATIENTS AND METHODS: A retrospective, single-centre cohort study (2001-11) investigated outcome in adults receiving pristinamycin for MSSA BJI and pristinamycin-related adverse events (AEs). RESULTS: One hundred and two MSSA BJIs were assessed in 98 patients [chronic infection, 33.3%; and orthopaedic device-related infection (ODI), 67.6%]. Surgery was performed in 77.5% of total cases, and in all but three ODIs, associated with antibiotic therapy of a median total duration of 29.2 weeks. Pristinamycin was prescribed as a part of the initial intensive treatment phase (29.4%) and/or included in final maintenance therapy (83.3%) at a dose of 47.6 (45.5-52.6) mg/kg/day for 9.3 (1.4-20.4) weeks. AEs occurred in 13.3% of patients, consisting of gastrointestinal disorder (76.9%) or allergic reaction (23.1%), leading to treatment interruption in 11 cases. AEs were related to daily dose (OR, 2.733 for each 10 additional mg/kg/day; P = 0.049). After a follow-up of 76.4 (29.6-146.9) weeks, the failure rate was 34.3%, associated with ODI (OR, 4.421; P = 0.006), particularly when the implant was retained (OR, 4.217; P = 0.007). In most patients, the pristinamycin companion drug was a fluoroquinolone (68.7%) or rifampicin (21.7%), without difference regarding outcome. CONCLUSIONS:Pristinamycin is an effective, well-tolerated alternative therapeutic option in MSSA BJI, on condition that a daily dosage of 50 mg/kg is respected.
Authors: Melissa Depypere; Richard Kuehl; Willem-Jan Metsemakers; Eric Senneville; Martin A McNally; William T Obremskey; Werner Zimmerli; Bridget L Atkins; Andrej Trampuz Journal: J Orthop Trauma Date: 2020-01 Impact factor: 2.884
Authors: Qi Li; Jenna Pellegrino; D John Lee; Arthur A Tran; Hector A Chaires; Ruoxi Wang; Jesslyn E Park; Kaijie Ji; David Chow; Na Zhang; Axel F Brilot; Justin T Biel; Gydo van Zundert; Kenneth Borrelli; Dean Shinabarger; Cindy Wolfe; Beverly Murray; Matthew P Jacobson; Estelle Mühle; Olivier Chesneau; James S Fraser; Ian B Seiple Journal: Nature Date: 2020-09-23 Impact factor: 69.504