Rifampin Use for Management of Surgical Site Infections
Moderate evidence supports that rifampin, as a second antimicrobial, increases the probability of treatment success for staphylococcal infections in the setting of retained orthopaedic implants.
Management of Surgical Site Infections
Endorsed by: POSNA, AANA, APTA, MIS, OTA
MODERATE RECOMMENDATION Rationale
Very few high quality studies were identified regarding the optimal antibiotic treatment regarding specific microbes. One high quality study (Zimmerli 1998) and one low-quality studies (El Helou 2010) addressed the addition of Rifampin and its effect on infection resolution in the setting of debridement and implant retention.
In the high quality study Zimmerli 1998 examined the role of rifampin in the setting of a retained fracture fixation implants and total joint prostheses with Staphylococcal infections. Patients who were randomized to receive rifampin as part of their treatment regimen had a lower risk of treatment failure.
- El Helou,O.C., Berbari,E.F., Lahr,B.D., Eckel-Passow,J.E., Razonable,R.R., Sia,I.G., Virk,A., Walker,R.C., Steckelberg,J.M., Wilson,W.R., Hanssen,A.D., Osmon,D.R. Efficacy and safety of rifampin containing regimen for staphylococcal prosthetic joint infections treated with debridement and retention. Eur J Clin Microbiol.Infect.Dis 2010/8; 8: 961-967
- Zimmerli,W., Widmer,A.F., Blatter,M., Frei,R., Ochsner,P.E. Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. 1998/5/20; 19: 1537-1541