Clindamycin in Prosthetic Joint Infections Caused by Staphylococcus (CISTA)

Study Overview
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Brief Summary
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The alternatives to the combination of Fluoroquinolone and Rifampicin in prosthetic joint infections (PJI) caused by staphylococcus are currently unclear. Clindamycin is prescribed as dual therapy in this indication, and provides many advantages. We conducted a multicenter retrospective observational study evaluating the efficacy and safety of Clindamycin in prosthetic joint infections due to staphylococcus between January 2013 and December 2019.

Official Title
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Clindamycin in Prosthetic Joint Infections Caused by Staphylococcus

Conditions
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Prosthetic Joint Infection, Staphylococcus

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with PJI defined according to the IDSA. Infection must be mono-microbial or multi-microbial with Staphylococcus spp sensitive to Clindamycin. Infection may be acute or chronic, nosocomial or community-acquired. Patient having received a curative treatment with Clindamycin. Exclusion Criteria: Patients with osteitis, osteomyelitis, septic arthritis in native joints, diabetic foot infections, spondylodiscitis, infections in external fixator, surgical site infections following neurosurgical management, bedsores, skin and soft tissue infections. Patients with mono-microbial infections other than Staphylococcus, multi-microbial infections including other bacteria than Staphylococcus, suspected Osteoarticular Infection without microbial identification. Patients with clindamycin-resistant Staphylococcal PJI, constitutive MLSb phenotype. Patients having received suspensive treatment with Clindamycin. Patients treated with Clindamycin as last line of treatment for a duration of less than 14 days. Patients refusing to participate Patients under legal protection (guardianship, curatorship, ..)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 120 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Clindamycin and Rifampicin<br>Patients treated with Clindamycin and Rifampicin | |
| Clindamycin and Fluoroquinolone<br>Patients treated with Clindamycin and Fluoroquinolone | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Failure of Clindamycine | New diagnosis of PJI at the same site, caused by the same microbial agent | within 2 years of the diagnosis (within one year for patients diagnosed in December 2019) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety of Clindamycin | Safety of Clindamycin in the treatment of PJI | During the treatment and 6 month after | 
| Correlation between failure of Clindamycin and blood level of Clindamycin |  | within 2 years of the diagnosis (within one year for patients diagnosed in December 2019) |