Rifampicin does not reduce moxifloxacin concentrations at the site of infection and may not improve treatment outcome of a one-stage exchange surgery protocol of implant-associated osteomyelitis lesions in a porcine model.
Implant-associated osteomyelitis
microdialysis
moxifloxacin
one-stage exchange
rifampicin
Journal
APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
ISSN: 1600-0463
Titre abrégé: APMIS
Pays: Denmark
ID NLM: 8803400
Informations de publication
Date de publication:
28 Dec 2023
28 Dec 2023
Historique:
received:
14
05
2023
accepted:
23
11
2023
medline:
28
12
2023
pubmed:
28
12
2023
entrez:
28
12
2023
Statut:
aheadofprint
Résumé
We aimed to evaluate moxifloxacin steady-state concentrations in infected bone and soft tissue and to explore the additive microbiological and pathological treatment effect of rifampicin to standard moxifloxacin treatment of implant-associated osteomyelitis (IAO). 16 pigs were included. On Day 0, IAO was induced in the proximal tibia using a susceptible Staphylococcus aureus strain. On Day 7, the pigs underwent one-stage exchange surgery of the IAO lesions and were randomized to receive seven days of intravenous antibiotic treatment of either rifampicin combined with moxifloxacin or moxifloxacin monotherapy. On Day 14, microdialysis was applied for continuous sampling (8 h) of moxifloxacin concentrations. Microbiological, macroscopical pathology, and histopathological analyses were performed postmortem. Steady-state moxifloxacin area under the concentration-time curve was lower in the combination therapy group in plasma (total) and subcutaneous tissue compartments (infected and noninfected) (p < 0.04), while no differences were found in bone compartments. No additional treatment effect of rifampicin to moxifloxacin treatment was found (p = 0.57). Conclusive, additive rifampicin treatment does not reduce moxifloxacin concentrations at the infection site. Rifampicin treatment may not be necessary in a one-stage exchange treatment of IAO. However, our sample size and treatment period may have been too small and short to reveal true clinical differences.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal
Organisme : Aarhus Universitets Forskningsfond
Organisme : Direktør Emil C. Hertz og Hustru Inger Hertz Fond
Organisme : Frimodt-Heineke Fonden
Organisme : Gigtforeningen
Organisme : Grosserer A.V. Lykfeldt og Hustrus Legat
Organisme : Kai Lange og Gunhild Kai Langes Fond
Organisme : Oda og Hans Svenningsens Fond
Organisme : Riisfort Fonden
Informations de copyright
© 2023 Scandinavian Societies for Pathology, Medical Microbiology and Immunology.
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