Treatment with linezolid and rifampicin for 18 months for recurrent infection of a megaprosthesis in a patient with Ewing's sarcoma

Prugger, V.; Egner, S.; Windhager, Reinhard; Mitteregger, Martin; Bertha, G.; Wenisch, C.

doi:10.1016/j.ijantimicag.2004.09.008

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…In vitro time-kill experiments showed a potential additive effect between linezolid and rifampin against MRSA (12). However, only case reports or small case series describing the treatment of implant-associated infections with linezolid and rifampin exist (2,16,19,26).…”

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Linezolid Alone or Combined with Rifampin against Methicillin-Resistant Staphylococcus aureus in Experimental Foreign-Body Infection

Baldoni

Haschke

Rajacic

et al. 2009

Antimicrob Agents Chemother

108

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We investigated the activity of linezolid, alone and in combination with rifampin (rifampicin), against a methicillin-resistant Staphylococcus aureus (MRSA) strain in vitro and in a guinea pig model of foreign-body infection. The MIC, minimal bactericidal concentration (MBC) in logarithmic phase, and MBC in stationary growth phase were 2.5, >20, and >20 g/ml, respectively, for linezolid; 0.01, 0.08, and 2.5 g/ml, respectively, for rifampin; and 0.16, 0.63, >20 g/ml, respectively, for levofloxacin. In time-kill studies, bacterial regrowth and the development of rifampin resistance were observed after 24 h with rifampin alone at 1؋ or 4؋ the MIC and were prevented by the addition of linezolid. After the administration of single intraperitoneal doses of 25, 50, and 75 mg/kg of body weight, linezolid peak concentrations of 6.8, 12.7, and 18.1 g/ml, respectively, were achieved in sterile cage fluid at Ϸ3 h. The linezolid concentration remained above the MIC of the test organism for 12 h with all doses. Antimicrobial treatments of animals with cage implant infections were given twice daily for 4 days. Linezolid alone at 25, 50, and 75 mg/kg reduced the planktonic bacteria in cage fluid during treatment by 1.2 to 1.7 log 10 CFU/ml; only linezolid at 75 mg/kg prevented bacterial regrowth 5 days after the end of treatment. Linezolid used in combination with rifampin (12.5 mg/kg) was more effective than linezolid used as monotherapy, reducing the planktonic bacteria by >3 log 10 CFU (P < 0.05). Efficacy in the eradication of cage-associated infection was achieved only when linezolid was combined with rifampin, with cure rates being between 50% and 60%, whereas the levofloxacin-rifampin combination demonstrated the highest cure rate (91%) against the strain tested. The linezolid-rifampin combination is a treatment option for implantassociated infections caused by quinolone-resistant MRSA.

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confidence: 99%