Pristinamycin in the Treatment of MSSA Bone and Joint Infection

Hospices Civils de Lyon102 enrolled

Overview

Staphylococcus aureus represents the leading pathogen implicated in bone and joint infection (BJI), usually requiring prolonged combination antimicrobial therapy, which may be particularly challenging in the case of MDR bacteria and/or for patients with multiple drug intolerance. In the absence of new well-tolerated oral antistaphylococcal drugs, older antibiotics must be considered, such as the pristinamycin. However, pristinamycin is not currently licensed for treatment of staphylococcal BJI and lack of clinical data prevents it from being considered as a reliable alternative therapeutic option in current guidelines. The aim of this study is to evaluate pristinamycin (efficacy and tolerance) in the treatment of MSSA bone and joint infection (BJI).

Study Type

OBSERVATIONAL

Enrollment

102

Conditions

Methicillin Susceptible Staphylococcus Aureus (MSSA) Infection Bone and Joint Infection

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

* Inclusion Criteria: * All patients receiving pristinamycin as a part of treatment for an MSSA BJI and followed up between 2001 and 2011 in the infectious diseases department of Hospices Civils de Lyon (HCL) * Exclusion Criteria: * Patients with BJI related to diabetic foot or decubitus ulcer

Locations (1)

Outcomes

Primary Outcomes

Efficacy of pristinamycin in MSSA bone and joint infection

Outcome of patients having had pristinamycin is described in this part. The follow up of the patients after termination of antimicrobial treatment is almost 80 weeks. Treatment failure included: persisting infection under appropriate antimicrobial therapy, relapse after interruption of antimicrobial therapy, septic indication for surgical revision \> 5 days after primary surgery, superinfection; and/or death, if related to the BJI or to complication of its management.

Time frame: 80 weeks

Secondary Outcomes

Tolerance of pristinamycin in MSSA bone and joint infection

The treatment duration could be long (several weeks) as pristinamycin is also used as a long-term suppressive therapy in BJI; thus, we can have 45 weeks of treatment with pristinamycin. Pristinamycin-related adverse events (AEs) occurring during follow-up were noted and classified according to the Common Terminology Criteria for Adverse Events (CTCAE; National Cancer Institute, 2003). The accountability of pristinamycin in AE onset was left to the clinician's judgement, with the help of a pharmacovigilance specialist in doubtful cases.

Time frame: 45 weeks