Methods: A retrospective cohort of staphylococcal hip and knee PJI treated with daptomycin after debridement (I&D) or 2-stage exchange was identified by query of hospital coding records from 2009 to 2014, with subsequent chart review. All cases met Musculoskeletal Infection Society International Consensus criteria for PJI; all staphylococcal species were included. The primary endpoint was defined in debrided joints as retention of the prosthesis at 2-year followup, and for two-stage exchanges, as prosthesis retention for 2 years from reimplantation. Descriptive statistics were completed using the Fisher’s exact test for categorical variables and the Mann-Whitney U test for continuous variables.
Results: 241 patients with staphylococcal PJI were identified: 148 two-stages (112 [75%] had success at 2 years) and 95 I&Ds (44 [47%] had success at 2 years. 28 (19%) two-stages and 9 (10%) of debridements received daptomycin, of which 20 two-stages (72%) and 6 debridements (66%) reached a successful 2-year outcome. In univariate analysis, there was no association between success and receipt of daptomycin in patients with staphylococcal PJI (two-stages, p=0.71; debridement, p=0.63). There were no associations noted between outcome and age, sex, or BMI.
Conclusion: Daptomycin appeared no better or worse than comparator antibiotics in a relatively large retrospective cohort of staphylococcal hip and knee PJI patients, regardless of surgical strategy. Given its favorable convenience and toxicity profile, it is an attractive antibiotic choice for staphylococcal PJI despite its high cost.
A. Nocon, None
G. Westrich, None
B. Brause, None
M. Henry, None