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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 5, issue 2
J. Bone Joint Infect., 5, 82–88, 2020
https://doi.org/10.7150/jbji.41278
© Author(s) 2020. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 5, 82–88, 2020
https://doi.org/10.7150/jbji.41278
© Author(s) 2020. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 30 Mar 2020

Original full-length article | 30 Mar 2020

Assessing the Role of Daptomycin as Antibiotic Therapy for Staphylococcal Prosthetic Joint Infection

Alberto V. Carli1, Andy O. Miller2, Milan Kapadia2, Yu-fen Chiu1, Geoffrey H. Westrich1, Barry D. Brause2, and Michael W. Henry2 Alberto V. Carli et al.
  • 1Hospital for Special Surgery, Division of Adult Reconstruction & Joint Replacement, 535 East 70th Street, New York, NY 10065, USA
  • 2Hospital for Special Surgery, Infectious Disease Division, 535 East 70th Street, New York, NY 10065, USA

Keywords: prosthetic joint infection, daptomycin, antibiotics, revision arthroplasty, implant retention, staphylococcal

Abstract. Background: The role of daptomycin, a potent, safe, convenient anti-staphylococcal antibiotic, in treatment of prosthetic joint infection (PJI) is unclear. We evaluated our experience with the largest cohort of patients with staphylococcal PJI managed with daptomycin.

Methods: A cohort of staphylococcal hip and knee PJI treated with daptomycin was identified by hospital records from 2009 to 2016. All cases met Musculoskeletal Infection Society International Consensus criteria for PJI. The primary endpoint was 2 year prosthesis retention. Univariate analyses and regression statistics were calculated.

Results: 341 patients with staphylococcal PJI were analyzed. 154 two-stages (77%) and 74 DAIR procedures (52%) met criteria for treatment success at 2 years. 77 patients were treated with daptomycin, of which 34 two-stages (68%) and 15 DAIRs (56%) achieved treatment success. Pairwise and regression analysis found no association between treatment success and daptomycin use. Organism (DAIR only) and Charlson Comorbidity Index scores (DAIR and two-stage) were significantly associated with treatment outcome. Six daptomycin patients (7.8%) had adverse side effects.

Discussion: Daptomycin fared no better or worse than comparable antibiotics in a retrospective cohort of staphylococcal hip and knee PJI patients, regardless of surgical strategy.

Conclusion: The convenient dosing, safety, and potency of daptomycin make it an attractive antibiotic for staphylococcal PJI. However, these advantages must be weighed against higher costs and rare, but serious side effects.

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