Impact of rifampicin dose in bone and joint prosthetic device infections due to Staphylococcus spp: a retrospective single-center study in France

Background Prosthetic joint infections (PJI) are a major cause of morbidity and mortality burden worldwide. While surgical management is well defined, rifampicin (RIF) dose remains controversial. The aim of our study was to determine whether Rifampicin dose impact infection outcomes in PJI due to Staphylococcus spp. Methods single-center retrospective study including 411 patients with PJI due to Rifampicin-sensitive Staphylococcus spp. Rifampicine dose was categorized as follow: < 10 mg/kg/day, 10–20 mg/kg/day or > 20 mg/kg/day. The primary endpoint was patient recovery, defined as being free of infection during 12 months after the end of the initial antibiotic course. Results 321 (78%) received RIF for the full antibiotic course. RIF dose didn’t affect patients recovery rate with 67, 76 and 69% in the < 10, 10–20 and > 20 mg/kg/day groups, respectively ( p = 0.083). In univariate analysis, recovery rate was significantly associated with gender ( p = 0.012) but not to RIF dose, or Staphylococcus phenotype ( aureus or coagulase-negative). In multivariate analysis, age (p = 0.01) and treatment duration ( p < 0.01) were significantly associated with recovery rate. Conclusion These data suggest that lower doses of RIF are as efficient and safe as the recommended high-dose French regimen in the treatment of PJI.