When should rifampin be added to the regimen of antibiotics for management of patients with periprosthetic joint infections (PJIs) undergoing surgical treatment?

When should rifampin be added to the regimen of antibiotics for management of patients with periprosthetic joint infections (PJIs) undergoing surgical treatment?

Authors: Katherine Belden, Werner Zimmerli, Christian Lausmann, Mustafa Citak, Akos Zahar

RECOMMENDATION: Rifampin should be considered in the treatment of staphylococcal PJIs in patients managed surgically with debridement, antibiotics and implant retention (DAIR) or single-stage exchange where activity against biofilm is required. Rifampin should only be used in combination therapies, with the best reported combination appearing to be with a fluoroquinolone.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 96%, Disagree: 2%, Abstain: 2% (Unanimous, Strongest Consensus)

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