Clinical Trial: Daptomycin With Rifampin for Treatment of Staphylococcal Prosthetic Joint Infection

Study Status: Terminated
Recruit Status: Unknown status
Study Type: Interventional

Official Title: Efficacy and Safety of Daptomycin (With or Without Rifampin) in the Treatment of Staphylococcal Hip, Knee and Shoulder Prosthetic Joint Infection

Brief Summary: To determine the outcome and safety of a combined antimicrobial treatment involving daptomycin and surgical approach involving retention or short-interval two-stage exchange of the implant. Patients with hip, knee and shoulder Prosthetic Joint Infection (PJI) caused by methicillin-susceptible and methicillin-resistant staphylococci will be included and followed during 2 years.

Detailed Summary:

In this prospective open observational clinical study (phase 2) patients with hip, knee and shoulder PJI (as defined below) caused by methicillin-susceptible and methicillin-resistant staphylococci will be included. An informed consent will be obtained prior to patient inclusion. Medical records will be prospectively abstracted for demographic characteristics, clinical, radiographic, laboratory and microbiologic data using a standardized case report form (CRF). After inclusion, intravenous daptomycin 10 mg/kg (calculated as actual body weight) is given once daily for 2-3 weeks, followed by oral rifampin-containing antibiotics for a total of 3 months (as outlined below).

Two surgical modalities will be applied according to the PJI treatment algorithm:

  • Open debridement and retention of the prosthesis (change of mobile parts): daptomycin will be combined with rifampin.
  • Two-stage exchange of the prosthesis with a short interval (2-3 weeks): daptomycin of the prosthesis: daptomycin will be used alone.

The decision whether the implant will be retained or removed is based on objective criteria of the treatment algorithm and is not subject to bias. All consecutive patients with a staphylococcal PJI infection of the hip, knee or shoulder prosthesis will be included, if no exclusion criterion is present, obviating the selection bias. Since not many specialized institutions are treating patients with PJI, we expect low number of patients.


Sponsor: Andrej Trampuz

Current Primary Outcome: Treatment efficacy (infection-free period) [ Time Frame: During study and 2 years after ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Safety of daptomycin (incidence of side effects) [ Time Frame: During study and 2 years after ]
  • Population pharmacokinetic profile of antibiotics (daptomycin, rifampin) will be evaluated through concentration measurements in plasma and drainage fluid. [ Time Frame: during treatment (12 weeks) ]


Original Secondary Outcome: Safety of daptomycin (incidence of side effects) [ Time Frame: During study and 2 years after ]

Information By: Centre Hospitalier Universitaire Vaudois

Dates:
Date Received: June 14, 2010
Date Started: June 2012
Date Completion: June 2016
Last Updated: June 24, 2012
Last Verified: June 2012