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J Bone Jt Infect. 2019 Mar 2;4(2):72-75. doi: 10.7150/jbji.22118. eCollection 2019.

Daptomycin versus Vancomycin as Post-Operative Empirical Antibiotic Treatment for Prosthetic Joint Infections: A Case-Control Study.

Author information

1
Infectious Diseases Department, University Hospital of Amiens, France.
2
Infectious Diseases Department, Gustave Dron Hospital of Tourcoing, France.
3
Faculty of Medicine of Lille, Lille University 2.
4
Laboratory of Microbiology, University Hospital of Lille, France.
5
Orthopaedic Surgery Unit, University Hospital of Lille, France.
6
Laboratory of Microbiology, Gustave Dron Hospital of Tourcoing, France.
7
Orthopedic Surgery Unit, Gustave Dron Hospital, France.
8
General Hospital of Béthune.

Abstract

Purpose: To compare safety and efficacy of Vancomycin (Van) versus Daptomycin (Dap) as post-operative empirical antibiotic treatment (PEAT) in patients with periprosthetic joint infections (PJIs). Methods: Medical charts of patients treated empirically with Van or Dap in the post-operative period of total hip/knee prosthesis septic revision until the results of intra-operative culture were reviewed. Cefotaxime, cefepime or aztreonam were used in combination with Dap or Van. Results: Twenty Dap patients were matched with 20 other Van patients according to the age and type of prosthesis. The ASA score and the distribution of the pathogens was similar in the two groups especially regarding the number of methicillin-resistant staphylococci. The mean duration of the PEAT was 6.07 ± 0.85 days. A total of 17 episodes of adverse events (AE) in 10 patients (25%) were recorded during the PEAT which led to discontinue the treatment in 5 patients, all of them treated with Van (P=0.02). At the end of a mean post-treatment follow-up of 618 +/- 219 days, 36 patients remained in remission of infection; 2 patients failed in each group. Conclusions: Our observations suggest that PEAT with Van for septic revision of PJIs is associated with a higher discontinuation rate due to AE but with a similar outcome than it is with Dap.

KEYWORDS:

Daptomycin; Vancomycin; empirical antibiotic treatment; prosthetic joint infection

Conflict of interest statement

Competing Interests: ES has received grants (meeting supports and speaker honoraria) from NOVARTIS SA. The other authors have declared that no competing interest exists.

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