El Zein, Said; Berbari, Elie F; Passerini, Matteo; Petri, Francesco; Maamari, Julian; Murad, M Hassan; Sendi, Parham; Tande, Aaron J (2024). Rifampin Based Therapy for Patients with Staphylococcus aureus Native Vertebral Osteomyelitis: A Systematic Review and Meta-Analysis. Clinical infectious diseases, 78(1), pp. 40-47. Oxford University Press 10.1093/cid/ciad560
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BACKGROUND
Native vertebral osteomyelitis (NVO) caused by Staphylococcus aureus is associated with high risk of treatment failure and increased morbidity. The role of rifampin-based therapy for the treatment of this condition is controversial. The goal of this systematic review and meta-analysis is to explore the efficacy and safety of rifampin-based therapy for the treatment of S. aureus NVO.
METHODS
We searched Cochrane, Embase, Medline, Scopus, and Web of Science databases for studies published up to May 2023, focusing on adults with NVO treated with or without rifampin containing regimens. A random-effects model meta-analysis estimated relative risks (RR) and risk difference (RD) with 95% confidence intervals (CI).
RESULTS
Thirteen studies (two RCTs and 11 comparative cohort studies), comprising 244 patients with S. aureus NVO who received rifampin and 435 who did not were analyzed. Meta-analysis showed that rifampin-based regimens were associated with lower risk of clinical failure (RD -14%; 95% CI: -19%, -8%; P < 0.001; I2 = 0%; RR 0.58, 95% CI: 0.37, 0.92, P = 0.02, I2 = 21%). Only one study reported on adverse events. All studies had a high or uncertain risk of bias, and the certainty of evidence was rated as very low.
CONCLUSION
Adjunctive rifampin therapy might be associated with lower risk of S. aureus NVO treatment failure, however, the low certainty of evidence precludes drawing definitive conclusions that would alter clinical practice. A randomized trial is necessary to corroborate these findings.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research 04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases |
UniBE Contributor: |
Sendi, Parham |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
1537-6591 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
19 Sep 2023 09:34 |
Last Modified: |
19 Sep 2024 00:25 |
Publisher DOI: |
10.1093/cid/ciad560 |
PubMed ID: |
37721158 |
Uncontrolled Keywords: |
NVO Spondylodiscitis native vertebral osteomyelitis rifampicin rifampin |
BORIS DOI: |
10.48350/186389 |
URI: |
https://boris.unibe.ch/id/eprint/186389 |
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