Status:

RECRUITING

Rifabutin Versus Rifampicin for Treatment of Staphylococcal PJI Treated With DAIR

Lead Sponsor:

Tourcoing Hospital

Conditions:

Prosthetic Infection

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

Rifampicin, is key in the treatment of staphylococcal PJIs. Rifabutin has a better profile of tolerance than rifampicin regarding the risk of interaction with concomitant medications and liver disorde...

Eligibility Criteria

Inclusion Criteria:

  1. Hip or knee Prosthetic joint infection treated by debridement, antibiotic therapy initiation and retention of prothesis (DAIR strategy)

  2. Infected with at least one of the following microorganisms:

    1. Staphylococcus aureus
    2. Coagulase-negative staphylococci
  3. Microorganisms susceptible to rifampicin and at least one other antibiotic suitable for the treatment of PJI (e.g., penicillin, fluoroquinolone, (doxy/mino)cycline, oxazolidinone, cotrimoxazole, daptomycin, glycopeptide, macrolide, fusidic acid), regardless of sensitivity to methicillin.

  4. Age ≥ 18 years

  5. At least 2 days of appropriate (i.e., covering pathogen(s) identified in the intraoperative samples) empirical agents are needed. Pre-randomization antimicrobial therapy could be: flucloxacillin, oxacillin, vancomycin, daptomycin. β-lactam plus β-lactamase-inhibitors (e.g. ampicillin+sulbactam, piperacillin+tazobactam), cephalosporins (except ceftazidime), carbapenems, teicoplanin, ceftaroline, ceftobiprole.

  6. Signed Inform consent

  7. Patient having the rights to French social insurance

  8. For women of childbearing potential i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile and excluding oestroprogestative-based contraception, any effective contraceptive: vasectomy (for men), intrauterine device copper, feminine sterilization, condom, sexual abstinence is required. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause

Exclusion Criteria:

  1. Suspicion of reduce absorption of oral treatment due to abdominal disorder Known or suspected malabsorption (imperfect absorption of food material by the small intestine)
  2. Polymicrobial infection due to other than staphylococcus species susceptible to rifampicin
  3. Known or suspected allergy to rifabutin and/or rifampicin
  4. Diagnosis of endocarditis associated to PJI
  5. Renal transplant or Chronic kidney disease with an eGFR of less than 30ml/min/1.73m²
  6. Other Solid Organ Transplant
  7. Liver cirrhosis, Child-Pugh score C
  8. Any other concomitant infection which required a prolonged course of intravenous antibiotic therapy
  9. Oestroprogestative-based contraception
  10. Oral anticoagulant drugs
  11. Other drug-drug interaction that contraindicated rifampicin or rifabutin
  12. Porphyria
  13. Unable to take oral treatment
  14. Receive empirical postoperative antibiotic treatment by rifampicin or rifabutin prior to randomization
  15. Pregnancy or lactating women
  16. Curator or guardianship or patient placed under judicial protection
  17. Participation in other interventional research during the study

Key Trial Info

Start Date :

November 8 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 1 2027

Estimated Enrollment :

436 Patients enrolled

Trial Details

Trial ID

NCT04672525

Start Date

November 8 2021

End Date

June 1 2027

Last Update

May 10 2022

Active Locations (30)

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Page 1 of 8 (30 locations)

1

CHU Amiens Picardie

Amiens, France

2

CHU Angers

Angers, France

3

CHU Besançon

Besançon, France

4

CH de Béthune

Béthune, France