Moxifloxacin-rifampicin combination for the treatment of non-staphylococcal Gram-positive orthopedic implant-related infections

Objective We aimed to describe the effectiveness and safety of the moxifloxacin–rifampicin combination in non-staphylococcal Gram-positive orthopedic implant-related infections. Methods Patients treated with the moxifloxacin–rifampicin combination for an implant-related infection from November 2014 to November 2016 were retrospectively identified from the database of the referral centers for bone and joint infections in Western France. Results Twenty-three cases of infection due to Streptococcus spp. (n = 12), Cutibacterium acnes (n = 6), and Enterococcus faecalis (n = 5) were included. Ten patients with hip prosthesis were included. Infection was polymicrobial in 11 cases. According to the MIC, moxifloxacin was 1.5 to 11.7 times as active as levofloxacin against non-staphylococcal Gram-positive bacteria. We reported an 81.8% success rate, and no severe adverse effect. Conclusion The moxifloxacin–rifampicin combination is a valuable alternative for the treatment of non-staphylococcal Gram-positive implant-related infections because of the good activity of moxifloxacin against these bacteria and the potential activity on the biofilm.