September 21, 2023
2 min read
Source/Disclosures
Published by:
Disclosures:
Tande reports receiving honoraria for medical writing from Uptodate and being an unpaid executive board member for Musculoskeletal Infection Society. No other authors report any relevant financial disclosures.
ADD TOPIC TO EMAIL ALERTS
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on .
”
data-action=”subscribe”>
Subscribe
We were unable to process your request. Please try again later. If you continue to have this issue please contact [email protected].
Back to Healio
Key takeaways:
- Rifampin-based regimens for treating S. aureus native vertebral osteomyelitis were associated with a lower risk of clinical failure.
- RR of clinical failure in for patients receiving rifampin was 0.58.
Rifampin-based regimens for treating Staphylococcus aureus native vertebral osteomyelitis were associated with lower risk of clinical failure, according to a study published in Clinical Infectious Diseases.
“Staphylococcus aureus native vertebral osteomyelitis (NVO) is a serious cause of morbidity and has a high risk of treatment failure. Antimicrobial therapy is the primary mode of therapy for most patients, highlighting the importance of identifying the best therapy,” Aaron J. Tande, MD, an infectious disease specialist in the Mayo Clinic’s Division of Public Health, Infectious Diseases and Occupational Medicine, told Healio.
Zein SE, et al. Clin Infect Dis. 2023;doi:10.1093/cid/ciad560.
“Rifampin combination therapy is sometimes used in other countries around the world for native vertebral infection but has not been specifically studied for this purpose. We noted this difference from American practice and wanted to evaluate the existing literature,” Tande said.
To do so, Tande and colleagues performed a systematic review and meta-analysis of studies gathered from Cochrane, Embase, Medline, Scopus and Web of Science databases and published through May 2023 that focused on adults with NVO treated with or without rifampin-containing regimens. In total, 13 studies — two randomized controlled trials and 11 comparative cohort studies — were analyzed and included in the study.
Overall, 244 patients with S. aureus NVO (35.9%) who received a rifampin-containing regimen and 435 (64.1%) who did not were assessed, with clinical failure being reported in 38 patients (15.6%) in the rifampin group and 95 patients (21.8%) in the group without rifampin.
The meta-analysis including all 679 patients with S. aureus NVO showed a 14% absolute risk reduction in clinical failure among patients treated with a rifampin-based regimen compared with those receiving standard-of-care treatment without rifampin (risk difference [RD] = –14%; 95% CI, –19% to –8%), whereas the RR of clinical failure in patients who received adjunctive rifampin was 0.58 (95% CI, 0.37-0.92).
These findings stayed consistent in a sensitivity analysis, which was conducted after excluding studies with less than five patients in each arm, less than 3 months mean follow-up or only assessing the outcome of relapse but not death.
The analysis still showed a significant absolute risk reduction in clinical failure with rifampin use (RD = –14%; 95% CI, –20% to –8%), according to the study.
“These are promising results that suggest that rifampin may improve outcomes of S. aureus NVO,” Tande said. “However, the limitations of this meta-analysis suggest that we need further study before enacting a clinical practice change.”
ADD TOPIC TO EMAIL ALERTS
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on .
”
data-action=”subscribe”>
Subscribe
We were unable to process your request. Please try again later. If you continue to have this issue please contact [email protected].
Back to Healio
