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)