Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampinbased regimen

Figures & data

Table 1.  Clinico-pathological characteristics of patients with and without joint infection after primary hip replacement

Variable	Infection	No Infection	P-value
Age (years)
median	71	68	0.6
range	60–79	18–96
Sex
Male	8	369	0.4
Female	6	436
BMI
median	33	28	0.01
range	22–42	15–53	0.01
< 30	4	516	0.01
≥30	10	289
Co-morbidities
Median (range)	3 (1–7)	2 (0–9)	0.07
≤2	6	523	0.02
< 2	8	282
Diabetes
Yes	4	83	0.08
No	10	722
Smoking
Yes	2	89	0.9
No	12	716
Cardiovacular
Yes	10	456	0.4
No	4	349
Gastrointestinal
Yes	5	164	0.3
No	9	641
Operation time (min)
median (range)	95	100	0.8
range)	50–190	50–295
Implant
Cementless	2	271	0.8
Cemented	6	378
Hybrid	6	156
Approach
Lateral	12	687	0.7
Posterior	2	118
Drain tube
Yes	13	731	0.8
No	1	74
Drainage (mL)
median	360	350	0.8
range	80–1130	0–2840
Anesthesia
Spinal	13	727	0.9
GA	1	78
Preoperative hemoglobin
median	133	136	0.4
range	99–147	91–181
Transfusion (U)
median (range)	2 (1–4)	2 (1–10)
Yes	7	302	0.5
No	7	503

BMI: body mass index; GA: general anesthesia.

Table 2.  Organism, antiobiotic, duration of therapy, and outcome

Patient	Organism^a	Antiobiotic^b	Initial ESR/CRP^c	Latest ESR/CRP^c	Duration (months)	Follow-up^c (months)	Outcome
1	E. coli	Cip	43/11	17/<5	indefinite	61	Retained
2	MRSA	Cip, Rif	63/148	66/36	24	30	Retained
3	MRSA	Rif, Fus	42/212	64/8	6	21	Girdlestone
4	MSSA/B-hemo., strep. sens.	Rif, Cip, Aug	86/297	22/16	12	15	Retained
5	MSSA	Rif, Fus	71/170	10/<5	18	37	Retained
6	Gp B Streptoccocus	Clin	96/175	20/8	indefinite	31	Retained
7	MRSA/Enterococcus	Rif, Fus, Pen	70/94	23/<5	6	38	2 stage rev.
8	MRSA, MRSE, E. faecalis	Rif, Fus, Clin, Amox	33/7	40/21	24	35	Retained
9	MRSA	Rif, Fus	62/38	46/6	20	24	Retained
10	MRSE/coag. neg.
	Staphyloccocus/Klebsiella	Rif, Fus, Aug	16/18	15/8	4	14	Retained
11	MSSA	Rif, Fus	123/316	11/<5	18	18	Retained
12	MRSA/
	Enterobacter aerogenes	Rif, Fus	35/244	40/9	12	17	Retained
13	MRSA	Rif, Fus	63/439	66/36	Indefinite	17	2 stage rev.
14	MRSE	Rif, Fus	123/316	11/<5	12	17	Retained

^aMRSA: Methicillin-resistant Staphylococcus aureus;

 MRSE: Methicillin-resistant Staphylococcus epidermidis;

 MSSA: Methicillin-sensitive Staphylococcus aureus;

 E. faecalis: Enterococcus faecalis;

 E. coli: Eschericia coli.

^bCip: Ciprofloxacin (500 mg 12-hourly); Rif: Rifampicin (300 mg 8-hourly); Fus: fusidic acid (500 mg 8-hourly);

 Aug: Augmentin DF (1 g 8-hourly); Clin: clindamycin (300 mg 6-hourly); Pen: penicillin (1 g 6-hourly);

 Amox: amoxicillin (1 g 8-hourly).

^cESR: erythrocyte sedimentation rate; CRP: C-reactive protein.

^dAfter cessation of antibiotics.

Table 3.  Intravenous antibiotic treatment following diagnosis

Patient no.	Type	Dose (g)	Frequency	Days of treatment
1	vancomycin	1	daily	3
	kefzol	1	8-hourly	7
	Revision:
	vancomycin	1	12-hourly	14
2	vancomycin	1	12-hourly	28
3	vancomycin	1	12-hourly	14
4	vancomycin	1	daily	14
5	vancomycin	1	12-hourly	14
	ceftriaxone	1	daily	7
6	penicillin	1.8	6-hourly	7
7	vancomycin	1	daily	14
8	vancomycin	1	12-hourly	10
	timentin	3.1	6-hourly	7
9	flucloxacillin	1	6-hourly	5
	vancomycin	1	12-hourly	14
10	cephazolin	2	8-hourly	10
11	flucloxacillin	1	6-hourly	10
12	vancomycin	1	12-hourly	5
	penicillin	2.4	4-hourly	7
	flucloxicllin	2	4-hourly	14
	cephazolin	3	6-hourly	7
13	cephalothin	2	6-hourly	2
	ampicillin	2	6-hourly	20
14	dicloxacillin	2	6-hourly	5
	cephazolin	2	8-hourly	3
	ceftriaxone	2	daily	7