{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:08:38Z","timestamp":1788793718283,"version":"build-2803163510"},"reference-count":101,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background. Osteoarticular infections (OAI)\u2014including prosthetic joint infections (PJI), fracture-related infections (FRI), and osteomyelitis\u2014are challenging to cure because bacterial biofilm on implant surfaces confers up to 1000-fold antibiotic tolerance, driving chronicity and relapse. Rifampicin, through its bactericidal activity against quiescent, biofilm-embedded bacteria and excellent oral bioavailability, occupies a pivotal role in managing Gram-positive OAI. Methods. This comprehensive narrative review synthesises mechanistic, preclinical, and clinical evidence on rifampicin across the three major osteoarticular infection types and by causative pathogen. PubMed\/MEDLINE, Embase, Scopus, and the Cochrane Library were searched (January 1990\u2013June 2026); of several hundred candidate records identified, the 101 most relevant were selected for narrative synthesis. Results. The strongest evidence supports rifampicin in staphylococcal PJI managed with debridement, antibiotics, and implant retention (DAIR), with fluoroquinolones as optimal companions; monotherapy invariably selects resistant mutants. This benefit is expected to extend beyond PJI to other osteoarticular infections managed with hardware retention\u2014fracture-related infection and implant-associated osteomyelitis\u2014given the shared biofilm target on retained metalwork. Benefit is attenuated in implant-exchange procedures, and evidence for streptococci, Cutibacterium acnes, and enterococci remains insufficient for firm recommendations. Conclusions. Rifampicin remains a valuable, difficult-to-replace agent in staphylococcal PJI treated with DAIR, provided it is introduced after surgical source control and combined with a fluoroquinolone. Observational data suggest possible benefit from introduction beyond 5 days post-debridement and courses of at least 14 days, but each threshold rests on a single study and requires confirmation. High-quality randomised trials targeting others OAI with implant retention, non-staphylococcal pathogens, optimal dosing, and treatment duration are needed.<\/jats:p>","DOI":"10.3390\/antibiotics15090872","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:53:28Z","timestamp":1788789208000},"page":"872","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rifampicin in Osteoarticular Infections: A Comprehensive Review of Current Evidence"],"prefix":"10.3390","volume":"15","author":[{"given":"France","family":"Laurent","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire (CHU) Helora, 7000 Mons, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-2346","authenticated-orcid":false,"given":"Jean Cyr","family":"Yombi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/cis803","article-title":"Diagnosis and management of prosthetic joint infection: Clinical practice guidelines by the Infectious Diseases Society of America","volume":"56","author":"Osmon","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1128\/CMR.00111-13","article-title":"Prosthetic joint infection","volume":"27","author":"Tande","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"654","DOI":"10.2174\/1874325001610010654","article-title":"Advances in diagnosis and treatment of periprosthetic joint infections","volume":"10","author":"Patel","year":"2016","journal-title":"Open Orthop. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1302\/2046-3758.106.BJR-2021-0167.R1","article-title":"Fracture-related Infection","volume":"10","author":"Baertl","year":"2021","journal-title":"Bone Jt. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.injury.2016.09.019","article-title":"Infection after fracture fixation: Current surgical and microbiological concepts","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.injury.2017.08.040","article-title":"Fracture-related infection: A consensus on definition from an international expert group","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00402-019-03287-4","article-title":"General treatment principles for fracture-related infection: Recommendations from an international expert group","volume":"140","author":"Metsemakers","year":"2020","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1126\/science.284.5418.1318","article-title":"Bacterial biofilms: A common cause of persistent infections","volume":"284","author":"Costerton","year":"1999","journal-title":"Science"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6585","DOI":"10.4049\/jimmunol.1002794","article-title":"Staphylococcus aureus biofilms prevent macrophage phagocytosis and attenuate inflammation in vivo","volume":"186","author":"Thurlow","year":"2011","journal-title":"J. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ijantimicag.2013.02.018","article-title":"In vitro susceptibility to antibiotics of staphylococci in biofilms isolated from orthopaedic infections","volume":"41","author":"Esteban","year":"2013","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1001\/jama.279.19.1537","article-title":"Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: A randomized controlled trial","volume":"279","author":"Zimmerli","year":"1998","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e01746-18","DOI":"10.1128\/AAC.01746-18","article-title":"Role of rifampin against staphylococcal biofilm infections in vitro, in animal models, and in orthopedic-device-related infections","volume":"63","author":"Zimmerli","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"eadq8328","DOI":"10.1126\/scitranslmed.adq8328","article-title":"Export by a quorum sensing-controlled drug exporter underlies rifampicin\u2019s strong activity against staphylococcal biofilms","volume":"17","author":"Liu","year":"2025","journal-title":"Sci. Transl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jgar.2021.12.005","article-title":"Rifamycin resistance, rpoB gene mutation and clinical outcomes of Staphylococcus species isolates from prosthetic joint infections in Republic of Korea","volume":"28","author":"Lee","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lazarinis, S., Hailer, N., J\u00e4rhult, J., and Br\u00fcggemann, A. (2023). Incidence of rifampicin resistance in periprosthetic joint infection: A single-centre cohort study on 238 patients. Antibiotics, 12.","DOI":"10.3390\/antibiotics12101499"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ijid.2019.02.005","article-title":"Antibiotic penetration into bone and joints: An updated review","volume":"81","author":"Thabit","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1587436","DOI":"10.3389\/fcimb.2025.1587436","article-title":"The impact of rifampin on the efficacy of implant retention and prosthesis removal in staphylococcal periprosthetic joint infection","volume":"15","author":"Zhang","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Tonnelier, M., Bouras, A., Joseph, C., El Samad, Y., Brunschweiler, B., Schmit, J.-L., Mabille, C., and Lanoix, J.-P. (2021). Impact of rifampicin dose in bone and joint prosthetic device infections due to Staphylococcus spp: A retrospective single-centre study in France. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-05832-2"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jinf.2013.07.017","article-title":"Epidemiology of adverse events and Clostridium difficile-associated diarrhoea during long-term antibiotic therapy for osteoarticular infections","volume":"67","author":"Schindler","year":"2013","journal-title":"J. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5717","DOI":"10.1128\/AAC.01236-13","article-title":"In vitro efficacies and resistance profiles of rifampin-based combination regimens for biofilm-embedded methicillin-resistant Staphylococcus aureus","volume":"57","author":"Tang","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1302\/2046-3758.115.BJR-2021-0395.R1","article-title":"Rifampicin restores extracellular organic matrix formation and mineralisation of osteoblasts after intracellular Staphylococcus aureus infection","volume":"11","author":"Alagboso","year":"2022","journal-title":"Bone Jt. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5194\/jbji-11-65-2026","article-title":"Gentamicin fails to eradicate Staphylococcus aureus biofilm in vitro, even in combination with rifampin","volume":"11","author":"Boot","year":"2026","journal-title":"J. Bone Jt. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107972","DOI":"10.1016\/j.cct.2025.107972","article-title":"Rifampicin combination therapy versus targeted antimicrobial monotherapy in the oral antimicrobial treatment phase of staphylococcal prosthetic joint infection (RiCOTTA-trial): Protocol for a randomized, controlled, open-label, non-inferiority trial","volume":"155","author":"Hanssen","year":"2025","journal-title":"Contemp. Clin. Trials"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Renz, N., Trampuz, A., and Zimmerli, W. (2021). Controversy about the role of rifampin in biofilm infections: Is it justified?. Antibiotics, 10.","DOI":"10.3390\/antibiotics10020165"},{"key":"ref_25","first-page":"ftw019","article-title":"Applying insights from biofilm biology to drug development\u2014Can a new approach be developed?","volume":"74","author":"Bjarnsholt","year":"2016","journal-title":"Pathog. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5080","DOI":"10.1128\/AAC.00702-13","article-title":"Vancomycin-rifampin combination therapy has enhanced efficacy against an experimental Staphylococcus aureus prosthetic joint infection","volume":"57","author":"Niska","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/jor.21519","article-title":"Mouse model of chronic post-arthroplasty infection: Noninvasive in vivo bioluminescence imaging to monitor bacterial burden for long-term study","volume":"30","author":"Pribaz","year":"2012","journal-title":"J. Orthop. Res."},{"key":"ref_28","first-page":"e01164-23","article-title":"Efficacy of ceftaroline and rifampin, alone or combined, in a rat model of methicillin-resistant Staphylococcus epidermidis osteomyelitis without implant","volume":"67","author":"Cercenado","year":"2023","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_29","first-page":"eabl6851","article-title":"Dynamic PET-facilitated modeling and high-dose rifampin regimens for Staphylococcus aureus orthopedic implant-associated infections","volume":"14","author":"Gordon","year":"2022","journal-title":"Sci. Transl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1002\/jor.25587","article-title":"Rat model of recalcitrant prosthetic joint infection using biofilm inocula","volume":"41","author":"Irwin","year":"2023","journal-title":"J. Orthop. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/apm.13371","article-title":"Rifampicin does not reduce moxifloxacin concentrations at the site of infection and may not improve treatment outcome of a one-stage exchange surgery protocol of implant-associated osteomyelitis lesions in a porcine model","volume":"132","author":"Vittrup","year":"2024","journal-title":"APMIS"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5194\/jbji-8-19-2023","article-title":"Systemic rifampicin shows accretion to locally implanted hydroxyapatite particles in a rat abdominal muscle pouch model","volume":"8","author":"Sebastian","year":"2023","journal-title":"J. Bone Jt. Infect."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Gidari, A., Sabbatini, S., Schiaroli, E., Perito, S., Francisci, D., Baldelli, F., and Monari, C. (2020). Tedizolid-Rifampicin Combination Prevents Rifampicin-Resistance on an In Vitro Model of Staphylococcus aureus Mature Biofilm. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.02085"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41522-026-00910-2","article-title":"Enzymes-enhanced antibiotic therapy reduces biofilms to undetectable levels in an implant-associated infection model","volume":"12","author":"Poilvache","year":"2026","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"123","DOI":"10.5194\/jbji-11-123-2026","article-title":"Septic arthritis and prosthetic joint infections: Microbial spectrum and evolving resistance patterns","volume":"11","author":"Gurler","year":"2026","journal-title":"J. Bone Jt. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1186\/s13018-020-01877-2","article-title":"Rifampicin combination therapy in staphylococcal prosthetic joint infections: A randomized controlled trial","volume":"15","author":"Karlsen","year":"2020","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.ijantimicag.2016.05.021","article-title":"Short-versus long-duration levofloxacin plus rifampicin for acute staphylococcal prosthetic joint infection managed with implant retention: A randomised clinical trial","volume":"48","author":"Euba","year":"2016","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e3386","DOI":"10.1093\/cid\/ciab426","article-title":"If, when, and how to use rifampin in acute staphylococcal periprosthetic joint infections, a multicentre observational study","volume":"73","author":"Beldman","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"ofab298","DOI":"10.1093\/ofid\/ofab298","article-title":"Outcome of debridement, antibiotics, and implant retention for staphylococcal hip and knee prosthetic joint infections, focused on rifampicin use: A systematic review and meta-analysis","volume":"8","author":"Scheper","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7150\/jbji.40333","article-title":"Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with debridement, antibiotics and implant retention (DAIR): A retrospective multicenter study in France","volume":"5","author":"Becker","year":"2020","journal-title":"J. Bone Jt. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/j.1469-0691.2007.01691.x","article-title":"Treatment of staphylococcal prosthetic joint infections with debridement, prosthesis retention and oral rifampicin and fusidic acid","volume":"13","author":"Aboltins","year":"2007","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1093\/jac\/dkp107","article-title":"One hundred and twelve infected arthroplasties treated with \u2019DAIR\u2019 (debridement, antibiotics and implant retention): Antibiotic duration and outcome","volume":"63","author":"Byren","year":"2009","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/cid\/cis746","article-title":"A large multicenter study of methicillin-susceptible and methicillin-resistant Staphylococcus aureus prosthetic joint infections managed with implant retention","volume":"56","author":"Murillo","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1093\/jac\/dkv481","article-title":"Importance of selection and duration of antibiotic regimen in prosthetic joint infections treated with debridement and implant retention","volume":"71","author":"Tornero","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"107359","DOI":"10.1016\/j.ijantimicag.2024.107359","article-title":"Effectiveness of rifampicin combination therapy for orthopedic implant-related infections: A systematic review and meta-analysis","volume":"64","author":"Kobayashi","year":"2024","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.arth.2022.03.072","article-title":"The use of rifampin in total joint arthroplasty: A systematic review and meta-analysis of comparative studies","volume":"37","author":"Kruse","year":"2022","journal-title":"J. Arthroplast."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"ofad491","DOI":"10.1093\/ofid\/ofad491","article-title":"Should we use rifampicin in periprosthetic joint infections caused by staphylococci when the implant has been exchanged? A multicenter observational cohort study","volume":"10","author":"Kramer","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107015","DOI":"10.1016\/j.ijantimicag.2023.107015","article-title":"Clinical outcomes of rifampicin combination therapy in implant-associated infections due to staphylococci and streptococci: A systematic review and meta-analysis","volume":"63","author":"Yusuf","year":"2024","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Prats-Peinado, L., Fern\u00e1ndez-Fern\u00e1ndez, T., M\u00e1rquez-G\u00f3mez, M., Matas-Diaz, J.A., S\u00e1nchez-Somolinos, M., de la Villa-Mart\u00ednez, S., Vaquero-Mart\u00edn, J., and Sanz-Ruiz, P. (2024). Do high doses of multiple antibiotics loaded into bone cement spacers improve the success rate in staphylococcal periprosthetic joint infection when rifampicin cannot be employed?. Antibiotics, 13.","DOI":"10.3390\/antibiotics13060538"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Junyent, J., Lora-Tamayo, J., Baraia-Etxaburu, J., S\u00e1nchez-Somolinos, M., Iribarren, J.A., Rodriguez-Pardo, D., Praena-Segovia, J., Sorl\u00ed, L., Bahamonde, A., and Riera, M. (2021). Implant removal in the management of prosthetic joint infection by Staphylococcus aureus: Outcome and predictors of failure in a large retrospective multicenter study. Antibiotics, 10.","DOI":"10.3390\/antibiotics10020118"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1093\/cid\/cir842","article-title":"Systemic antibiotic therapy for chronic osteomyelitis in adults","volume":"54","author":"Spellberg","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/jac\/48.6.927","article-title":"Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis","volume":"48","author":"Senneville","year":"2001","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_53","first-page":"1751","article-title":"A novel murine model of established Staphylococcus aureus biofilm implant infection","volume":"33","author":"Inzana","year":"2015","journal-title":"J. Orthop. Res."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Hasan, R., Wohlers, A., Shreffler, J., Mulinti, P., Ostlie, H., Schaper, C., Brooks, B., and Brooks, A. (2020). An Antibiotic-Releasing Bone Void Filling (ABVF) Putty for the Treatment of Osteomyelitis. Materials, 13.","DOI":"10.3390\/ma13225080"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1302\/0301-620X.98B9.38057","article-title":"Single-stage treatment of chronic osteomyelitis with a new absorbable, gentamicin-loaded, calcium sulphate\/hydroxyapatite biocomposite: A prospective series of 100 cases","volume":"98","author":"McNally","year":"2016","journal-title":"Bone Jt. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3930","DOI":"10.1016\/j.injury.2022.10.017","article-title":"Outcome and risk factors for recurrence of early onset fracture-related infections treated with debridement, antibiotics and implant retention: Results of a large retrospective multicentre cohort study","volume":"53","author":"Buijs","year":"2022","journal-title":"Injury"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jinf.2023.01.028","article-title":"The effect of guideline-based antimicrobial therapy on the outcome of fracture-related infections (EAT FRI Study)","volume":"86","author":"Corrigan","year":"2023","journal-title":"J. Infect."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"362","DOI":"10.5414\/CP204740","article-title":"Rifampicin in combination treatments for methicillin-resistant staphylococcal prosthetic joint infections: Claims database evaluation using a cohort of 52,588 hip arthroplasty patients","volume":"63","author":"Nitta","year":"2025","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jgar.2022.06.020","article-title":"Rifampicin resistance and risk factors associated with significantly lower recovery rates after two-stage revision in patients with prosthetic joint infection","volume":"30","author":"Krizsan","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"237","DOI":"10.5194\/jbji-11-237-2026","article-title":"Rifampin resistance and multidrug resistance or extensive drug resistance (MDR\/XDR) predict failure in monomicrobial Staphylococcus epidermidis periprosthetic joint infection (PJI)\u2014A 15-year single-centre cohort study","volume":"11","author":"Gabardo","year":"2026","journal-title":"J. Bone Jt. Infect."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3928\/01477447-20250618-01","article-title":"Outcomes of staphylococcal periprosthetic joint infections treated with rifampin and the potential role of rifabutin as a substitute when high-risk drug-drug interactions exist","volume":"48","author":"Leal","year":"2025","journal-title":"Orthopedics"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1017\/S0950268818001437","article-title":"Species and antimicrobial susceptibility testing of coagulase-negative staphylococci in periprosthetic joint infections","volume":"146","author":"Giordano","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"ref_63","first-page":"723","article-title":"RpoB mutations conferring rifampicin resistance in Staphylococcus epidermidis from prosthetic joint infections","volume":"80","author":"Edslev","year":"2025","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e0007121","DOI":"10.1128\/Spectrum.00071-21","article-title":"In vitro activity of rifampin, rifabutin, and rifapentine against enterococci and streptococci from periprosthetic joint infection","volume":"9","author":"Albano","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Fiaux, E., Titecat, M., Robineau, O., Lora-Tamayo, J., El Samad, Y., Etienne, M., Frebourg, N., Blondiaux, N., Brunschweiler, B., and Dujardin, F. (2016). Outcome of patients with streptococcal prosthetic joint infections with special reference to rifampin combinations. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1889-0"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1093\/cid\/cix227","article-title":"The Not-So-Good Prognosis of Streptococcal Periprosthetic Joint Infection Managed by Implant Retention: The Results of a Large Multicenter Study","volume":"64","author":"Senneville","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s42836-025-00341-y","article-title":"Treatment failure and associated risk factors for periprosthetic-joint infections caused by streptococci versus other etiologies: A single-center retrospective cohort study","volume":"7","author":"Borens","year":"2025","journal-title":"Arthroplasty"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"100201","DOI":"10.1016\/j.sipas.2023.100201","article-title":"Outcome of debridement, antibiotics and implant retention for streptococcal hip and knee prosthetic joint infections: A systematic review and meta-analysis","volume":"14","author":"Gerritsen","year":"2023","journal-title":"Surg. Pract. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1128\/AAC.05552-11","article-title":"Role of rifampin against Propionibacterium acnes biofilm in vitro and in an experimental foreign-body infection model","volume":"56","author":"Corvec","year":"2012","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_70","first-page":"96","article-title":"Results of surgical treatment and antibiotic therapy of patients with a Cutibacterium acnes orthopaedic implant infection","volume":"90","author":"Jacobs","year":"2019","journal-title":"Acta Orthop."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e1064","DOI":"10.1093\/cid\/ciaa1839","article-title":"The impact of surgical strategy and rifampin on treatment outcome in Cutibacterium periprosthetic joint infections","volume":"72","author":"Kusejko","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Saltiel, G., Meyssonnier, V., Kerroumi, Y., Heym, B., Lidove, O., Marmor, S., and Zeller, V. (2022). Cutibacterium acnes Prosthetic Joint Infections: Is Rifampicin-Combination Therapy Beneficial?. Antibiotics, 11.","DOI":"10.3390\/antibiotics11121801"},{"key":"ref_73","unstructured":"RIFACute Trial, and RIFACute Study Group (2022). Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections, TrialX. Initiated 2023."},{"key":"ref_74","first-page":"126","article-title":"Antibiotic regimens for gram-positive prosthetic joint infections","volume":"12","author":"Holmberg","year":"2015","journal-title":"J. Orthop."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1111\/1469-0691.12721","article-title":"Characteristics of prosthetic joint infections due to Enterococcus sp. and predictors of failure: A multi-national study","volume":"20","author":"Tornero","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2106\/JBJS.21.00549","article-title":"Moxifloxacin concentrations in the knee joint, tibial bone, and soft tissue when combined with rifampicin: A randomized porcine microdialysis study","volume":"104","author":"Slater","year":"2022","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.ijantimicag.2017.04.011","article-title":"Moxifloxacin plus rifampin as an alternative for levofloxacin plus rifampin in the treatment of a prosthetic joint infection with Staphylococcus aureus","volume":"51","author":"Tornero","year":"2018","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.medmal.2019.06.008","article-title":"Moxifloxacin-rifampicin combination for the treatment of non-staphylococcal Gram-positive orthopedic implant-related infections","volume":"49","author":"Fily","year":"2019","journal-title":"Med. Mal. Infect."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jinf.2015.03.013","article-title":"Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination","volume":"71","author":"Bernard","year":"2015","journal-title":"J. Infect."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7150\/jbji.37262","article-title":"Clinical outcome of antibiotic suppressive therapy in patients with a prosthetic joint infection after total hip replacement","volume":"4","author":"Leijtens","year":"2019","journal-title":"J. Bone Jt. Infect."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"962","DOI":"10.3109\/00365548.2011.608082","article-title":"Efficacy of a combined oral clindamycin-rifampicin regimen for therapy of staphylococcal osteoarticular infections","volume":"43","author":"Czekaj","year":"2011","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"ofac582","DOI":"10.1093\/ofid\/ofac582","article-title":"Adjunctive Rifampin Following Debridement and Implant Retention for Staphylococcal Prosthetic Joint Infection: Is It Effective If Not Combined with a Fluoroquinolone?","volume":"9","author":"Hewlett","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1111\/j.1469-0691.2009.02761.x","article-title":"Efficacy and tolerance of rifampicin-linezolid compared with rifampicin-cotrimoxazole combinations in prolonged oral therapy for bone and joint infections","volume":"15","author":"Nguyen","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1128\/AAC.01504-08","article-title":"Long-term follow-up trial of oral rifampin-cotrimoxazole combination versus intravenous cloxacillin in treatment of chronic staphylococcal osteomyelitis","volume":"53","author":"Euba","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s40121-014-0032-z","article-title":"A Retrospective Review of the Clinical Experience of Linezolid with or without Rifampicin in Prosthetic Joint Infections Treated with Debridement and Implant Retention","volume":"3","author":"Morata","year":"2014","journal-title":"Infect. Dis. Ther."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/jac\/39.2.235","article-title":"Oral treatment of Staphylococcus spp. infected orthopaedic implants with fusidic acid or ofloxacin in combination with rifampicin","volume":"39","author":"Drancourt","year":"1997","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1046\/j.1365-2710.2001.00380.x","article-title":"Outpatient parenteral antimicrobial therapy (OPAT) for the treatment of osteomyelitis: Evaluation of efficacy, tolerance and cost","volume":"26","author":"Bernard","year":"2001","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Dessert, V., Maurer, S.M., Maurer, M.S., Albrecht, D., Farshad, M., and U\u00e7kay, \u0130. (2025). Evaluating the Link Between Postoperative Timing of Rifampicin Introduction and the Clinical and Microbiological Outcomes of Orthopedic Staphylococcal Implant Infections. Antibiotics, 14.","DOI":"10.20944\/preprints202509.1930.v1"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.cmi.2016.10.002","article-title":"The use of rifampin in staphylococcal orthopaedic-device-related infections","volume":"23","author":"Sendi","year":"2017","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.jinf.2018.01.009","article-title":"Outcome of acute staphylococcal prosthetic joint infection treated with debridement, implant retention and antimicrobial treatment with short duration of rifampicin","volume":"76","author":"Scheper","year":"2018","journal-title":"J. Infect."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1435720","DOI":"10.3389\/fmicb.2024.1435720","article-title":"Antibiotics with antibiofilm activity\u2014Rifampicin and beyond","volume":"15","author":"Ferreira","year":"2024","journal-title":"Front. Microbiol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e01813-22","DOI":"10.1128\/spectrum.00384-22","article-title":"A case series of rifabutin use in staphylococcal prosthetic joint infections","volume":"10","author":"Monk","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1093\/jac\/dkab486","article-title":"Rifabutin versus rifampicin bactericidal and antibiofilm activities against clinical strains of Staphylococcus spp. isolated from bone and joint infections","volume":"77","author":"Thill","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"23241","DOI":"10.1038\/s41598-021-02709-x","article-title":"In vitro additive effects of dalbavancin and rifampicin against biofilm of Staphylococcus aureus","volume":"11","author":"Jacob","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"16156","DOI":"10.1038\/s41598-026-43963-1","article-title":"Evaluating the efficacy of delafloxacin and combination therapy against Staphylococcus aureus biofilms: Insights into activity in acidic environments","volume":"16","author":"Suss","year":"2026","journal-title":"Sci. Rep."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"e02231-19","DOI":"10.1128\/AAC.02231-19","article-title":"Evaluation of the activity of a combination of three bacteriophages alone or in association with antibiotics on Staphylococcus aureus embedded in biofilm or internalized in osteoblasts","volume":"64","author":"Kolenda","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1302\/2058-5241.6.210073","article-title":"A systematic review of phage therapy applied to bone and joint infections: An analysis of success rates, treatment modalities and safety","volume":"6","author":"McCallin","year":"2021","journal-title":"EFORT Open Rev."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e25.00212","DOI":"10.2106\/JBJS.OA.25.00212","article-title":"Continuous local antibiotic perfusion: A novel technique for the treatment of orthopaedic infections","volume":"11","author":"Choe","year":"2026","journal-title":"JBJS Open Access"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13063-025-09319-2","article-title":"Intra-articular antibiotic infusions versus intravenous antibiotic administration for infected knee arthroplasty: A study protocol for a randomized multicenter clinical trial","volume":"27","author":"Ji","year":"2026","journal-title":"Trials"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Berberich, C.E. (2025). Current Concepts of Local Antibiotic Delivery in Bone and Joint Infections\u2014A Narrative Review of Techniques and Clinical Experiences. Microorganisms, 13.","DOI":"10.3390\/microorganisms13102276"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Hanssen, J.L.J., van der Linden, H.M.J., van der Beek, M.T., van der Wal, R.J.P., Termaat, M.F., de Boer, M.G.J., and Scheper, H. (2025). Implementation of multidisciplinary team decisions on the management of complex bone and joint infections: An observational study. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-08329-0"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/9\/872\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:16:13Z","timestamp":1788790573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/9\/872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":101,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["antibiotics15090872"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15090872","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}