Safety and Tolerability of Fluoroquinolones in Patients with Staphylococcal Periprosthetic Joint Infections

• Published in: Clinical infectious diseases 2021-09, Vol.73 (5), p.850-856
• Main Authors: Vollmer, Nicholas J, Rivera, Christina G, Stevens, Ryan W, Oravec, Caitlin P, Mara, Kristin C, Suh, Gina A, Osmon, Douglas R, Beam, Elena N, Abdel, Matthew P, Virk, Abinash
• Format: Article
• Language: English
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/ciab145

Abstract Background Fluoroquinolones (FQs) are known to be accompanied by significant risks. However, the incidence of adverse events (ADEs) resulting in unplanned drug discontinuation when used for periprosthetic joint infections (PJIs) is currently unknown. Methods This study included 156 patients over the age of 18 treated for staphylococcal PJI with debridement, antibiotics, and implant retention between 1 January 2007 and 21 November 2019. Of the 156 patients, 64 had total hip arthroplasty (THA) and 92 had total knee arthroplasty (TKA) infections. The primary outcome was rate of unplanned drug discontinuation. Secondary outcomes included incidence of severe ADEs, unplanned rifamycin discontinuation, mean time to unplanned regimen discontinuation, and all-cause mortality. Results Overall, unplanned drug discontinuation occurred in 35.6% of patients in the FQ group and 3% of patients in the non-FQ group. The rate of unplanned discontinuation of FQ regimens as compared with non-FQ regimens was 27.5% vs 4.2% (P = .021) in THA infections and 42% vs 2.4% (P