Oral rifampin plus levofloxacin for treatment of chronic orthopedic implant-related infections / 中国矫形外科杂志

ABSTRACT

[Objective]To examine the effect and safety of the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections. [Methods]From March 2006 to December 2007,13 patients with chronic orthopedic implant-related infections were treated orally with rifampin ,600 mg/day,plus levofloxacin,600mg/day.The study group included 6 males and 7 females, with average age of 51.6 years (range, 17~75 years).During treatment,clinical follow-up was performed, including blood and differential counts ,erythrocyte sedimentation rate , and hepatic enzyme levels,C-reactive protein levels,and radiological data.Cure was defined as the absence of clinical signs and symptoms of infection (fever,local pain,redness,warmth,sinus tract infection ),ESR50 mg/l) without microbiological documentation of infection.[Results]Among 13 patients included in the study and evaluable for safety, one patient had gastrointestinal side effects and was not evaluable for treatment effectiveness. Twelve patients with chronic orthopedic implant-related infections , antibiotics were administrated orally for a total of 6 months . Two patients, on whom pseudoarthrosis presented, were treated with autologous bone graft and internal fixation subsequently. Ten of 12 patients with chronic orthopedic implant-related infections had successful outcomes . Those rates were determined after a post-treatment follow-up of 6 to 27 months (average, 24 months ).The overall success rate was 83.3% among 12 patients.Ten cases had been followed up,and no case had infection recurrence.[Conclusion]With nutrition support, the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections are effective methods.