Efficacy of a combined oral clindamycin-rifampicin regimen for therapy of staphylococcal osteoarticular infections

A majority of osteoarticular and implant-related infections are due to staphylococci and biofilm formation. Combined therapy including rifampicin is frequently recommended. Indeed, rifampicin penetrates biofilms and kills adherent staphylococci, but cannot be administered as monotherapy because of the rapid emergence of resistant mutants. While several antibiotic combinations including rifampicin have been implemented, evaluation of the clindamycin-rifampicin combination has been neglected, presumably because of the emergence of alternative combinations, such as quinolone-rifampicin, and the fear of potential antagonistic interactions.  Czekaj J, Dinh A, Moldovan A, Vaudaux P, Gras G, Hoffmeyer P, Lew D, Bernard L, Uçkay I. Scand J Infect Dis. 2011 Sep 15. [Epub ahead of print]PMID: 21916775 PDF