The tale of microencapsulated rifampicin: is it useful for the treatment of periprosthetic joint infection?

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López Torres, Irene Isabel and Vaquero Martín, Javier and Torres Suárez, Ana Isabel and Navarro García, Federico and Fraguas Sánchez, Ana Isabel and León Román, Víctor Estuardo and Sanz Ruiz, Pablo (2022) The tale of microencapsulated rifampicin: is it useful for the treatment of periprosthetic joint infection? International Orthopaedics . ISSN 0341-2695

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Official URL: https://doi.org/10.1007/s00264-021-05290-0




Abstract

Purpose
Microencapsulation techniques have allowed the addition of rifampicin to bone cement, but its in vivo efficacy has not been proven. The aim of our study is to determine the superiority of cement containing gentamicin and rifampicin microcapsules in the treatment of PJI versus cement exclusively containing gentamicin.

Methods
An S. aureus PJI was induced in 15 NZW rabbits. A week after inoculation, the first stage of replacement was carried out, and the animals were divided into two groups: group R received a spacer containing gentamicin and rifampicin microcapsules, and group C received a spacer containing gentamicin. Intra-articular release curve of rifampicin and infection and toxicity markers were monitored for four weeks post-operatively, when microbiological analysis was performed.

Results
The microbiological cultures showed a significantly lower growth of S. aureus in soft tissue (2.3·104 vs 0; p = 0.01) and bone (5.7·102 vs 0; p = 0.03) in the group with rifampicin microcapsules. No differences were found in systemic toxicity markers. Rifampicin release from the cement spacer showed higher concentrations than the staphylococcal MIC throughout the analysis.

Conclusion
The in vivo analyses demonstrated the superiority of cement containing gentamicin and rifampicin microcapsules versus the isolated use of gentamicin in the treatment of PJI in the rabbit model without serious side effects due to the systemic absorption of rifampicin. Given the increasing incidence of staphylococci-related PJI, the development of new strategies for intra-articular administration of rifampicin for its treatment has a high clinical impact.


Item Type:Article
Additional Information:

CRUE-CSIC (Acuerdos Transformativos 2021)

Uncontrolled Keywords:Prosthetic joint infection, Rifampicin, Bone cement, Rabbit
Subjects:Medical sciences > Medicine > Rheumatology
Medical sciences > Pharmacy > Pharmacology
ID Code:70565
Deposited On:17 Feb 2022 18:03
Last Modified:18 Feb 2022 11:12

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