Department of medical microbiology and infection prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of infectious diseases, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands.
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(7):695-701. doi: 10.1080/14787210.2023.2211263. Epub 2023 May 8.
A periprosthetic joint infection (PJI) is a major complication of arthroplasty. Treatment of PJI consists of surgical debridement with or without the exchange of the implant and long-term antimicrobial treatment. Rifampicin is regarded as one of the cornerstones of antimicrobial treatment for staphylococcal PJI, but the exact role of rifampicin for PJI in different clinical scenarios remains to be elucidated.
In this perspective article, an overview is provided of in vitro, in vivo and clinical studies that were the basis of the current guidelines and recommendations for rifampicin use in daily practice for PJI. Controversial issues on indication, dosing, timing, duration, and antibiotic drug interactions will be addressed. Finally, the most urgent clinical questions on rifampicin use that need answering in the nearby future will be formulated.
Many inquiries remain concerning the exact indications and clinical use of rifampicin in PJI. Randomized controlled trials are needed to answer these questions.
人工关节周围感染（PJI）是关节置换术的主要并发症。PJI 的治疗包括手术清创，可伴有或不伴有植入物的更换，以及长期抗菌治疗。利福平被认为是治疗葡萄球菌性 PJI 的抗菌治疗的基石之一，但利福平在不同临床情况下治疗 PJI 的确切作用仍有待阐明。
在这篇观点文章中，概述了体外、体内和临床研究，这些研究是当前指南和建议中利福平在 PJI 日常实践中使用的基础。将讨论适应证、剂量、时机、持续时间和抗生素药物相互作用等有争议的问题。最后，将制定出在不久的将来需要回答的关于利福平使用的最紧迫的临床问题。
关于利福平在 PJI 中的确切适应证和临床应用仍有许多疑问。需要进行随机对照试验来回答这些问题。
