Novel Use of Rifabutin and Rifapentine to Treat Methicillin-Resistant Staphylococcus aureus in a Rat Model of Foreign Body Osteomyelitis

Melissa J. Karau, Suzannah M. Schmidt-Malan, Mariana Albano, Jayawant N. Mandrekar, Christina G. Rivera, Douglas R. Osmon, Caitlin P. Oravec, Daniel J. Berry, Matthew P. Abdel, Robin Patel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Owing to patient intolerance or drug interactions, alternative agents to rifampin are needed for management of staphylococcal periprosthetic joint infection. In the current study, we evaluated rifabutin, rifapentine and rifampin, with and without vancomycin, in a rat model of foreign body osteomyelitis. Methods: Proximal tibiae were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and a Kirschner wire (K-wire) implanted in each. After 4 weeks of infection, rifampin, rifabutin, or rifapentine were administered, alone or with vancomycin. Tibiae and K-wires were cultured, and medians were reported as log10 colony-forming units (CFUs) per gram of bone or log10 CFUs per K-wire, respectively. Results: Rifampin, rifabutin or rifapentine administered with vancomycin yielded less MRSA from bones (0.10, 3.02, and 0.10 log10 CFUs/g, respectively) than did no treatment (4.36 log10 CFUs/g) or vancomycin alone (4.64 log10 CFUs/g) (both Pââ.02). The K-wires of animals receiving no treatment or vancomycin monotherapy recovered medians of 1.76 and 2.91 log10 CFUs/g per K-wire, respectively. In contrast, rifampin, rifabutin and rifapentine administered with vancomycin yielded medians of 0.1 log10 CFUs per K-wire, respectively. Rifampin resistance was detected in a single animal in the rifampin monotherapy group. Conclusions: Rifabutin or rifapentine with vancomycin were as active as rifampin with vancomycin against MRSA in rat foreign body osteomyelitis, suggesting that rifabutin and/or rifapentine may be alternatives to rifampin in the clinical management of staphylococcal periprosthetic joint infections.

Original languageEnglish (US)
Pages (from-to)1498-1504
Number of pages7
JournalJournal of Infectious Diseases
Volume222
Issue number9
DOIs
StatePublished - Nov 1 2020

Keywords

  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • osteomyelitis
  • periprosthetic joint infection (PJI)
  • rifabutin
  • rifampin
  • rifamycin
  • rifapentine
  • vancomycin

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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