Skip to main content

Advertisement

SpringerLink
Log in

Fusidic acid in a tertiary hospital: an observational study focusing on prescriptions, tolerance and susceptibility of Staphylococcus and Cutibacterium spp. strains from bone samples

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Adverse drug reactions of broad-spectrum fluoroquinolones or rifampicin are not uncommon during osteomyelitis and orthopaedic implant infections (OOII). Thus, we made an overview (i) of the prescription of fusidic acid (FA) and (ii) of FA susceptibility of Staphylococcus sp. and Cutibacterium sp. strains isolated from bone samples. All prescriptions of FA and all bone samples with positive culture for Staphylococcus sp. or Cutibacterium sp. (Reims University Hospital June 2017–May 2021) were included. All Staphylococcus aureus strains were considered as significant, whereas Coagulase-negative Staphylococcus and Cutibacterium spp. strains were not if these strains grew only on one sole sample. The antibiotic susceptibility of Staphylococcus sp. strains and the susceptibility to FA of Cutibacterium sp. strains had been determined using disk diffusion methods, as described for Staphylococcus sp. in the CASFM/EUCAST guidelines. The mean FA consumption was 0.6 daily defined doses/1000 patient days. FA was prescribed for OOII due to Staphylococcus sp. and Cutibacterium sp. in 24 and 2 cases, respectively. Among 401 Staphylococcus sp. strains, there were 254 S. aureus (63.3%), 84 methicillin-resistant (20.9%) and 333 FA-susceptible (83.0%) strains. S. aureus and methicillin-sensitive strains were more likely to be susceptible to FA (p < 0.001). Among 39 Cutibacterium sp. strains, the FA inhibition zone diameter geometric mean was 28.6 mm (24–35 mm), suggesting that all these strains could be considered as susceptible to FA. These data suggested that FA could be more frequently used in OOII due to Staphylococcus sp. and Cutibacterium sp., subject to the absence of other resistant bacteria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Yes.

Code availability

Not applicable.

References

  1. Drago L, De Vecchi E, Bortolin M, Zagra L, Romanò CL, Cappelletti L (2017) Epidemiology and antibiotic resistance of late prosthetic knee and hip infections. J Arthroplasty 32(8):2496–2500

    Article  Google Scholar 

  2. Paharik AE, Schreiber HL 4th, Spaulding CN, Dodson KW, Hultgren SJ (2017) Narrowing the spectrum: the new frontier of precision antimicrobials. Genome Med 9(1):110

    Article  Google Scholar 

  3. Armand-Lefèvre L, Angebault C, Barbier F, Hamelet E, Defrance G, Ruppé E et al (2013) Emergence of imipenem-resistant gram-negative bacilli in intestinal flora of intensive care patients. Antimicrob Agents Chemother 57(3):1488–95

    Article  Google Scholar 

  4. (2009) Société de Pathologie Infectieuse de Langue Française (SPILF); Collège des Universitaires de Maladies Infectieuses et Tropicales (CMIT); Groupe de Pathologie Infectieuse Pédiatrique (GPIP); Société Française d'Anesthésie et de Réanimation (SFAR); Société Française de Chirurgie Orthopédique et Traumatologique (SOFCOT); Société Française d'Hygiène Hospitalière (SFHH) et al. Clinical practice recommendations. Osteoarticular infections on materials (prosthesis, implant, osteosynthesis. Med Mal Infect 39(11):815–63.

  5. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM et al (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 56(1):e1–e25

    Article  Google Scholar 

  6. Benkabouche M, Racloz G, Spechbach H, Lipsky BA, Gaspoz JM, Uçkay I (2019) Four versus six weeks of antibiotic therapy for osteoarticular infections after implant removal: a randomized trial. J Antimicrob Chemother 74(8):2394–2399

    Article  CAS  Google Scholar 

  7. Zimmerli W, Widmer AF, Blatter M, Frei R, Ochsner PE (1998) Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. JAMA 279(19):1537–41

    Article  CAS  Google Scholar 

  8. Bernard A, Kermarrec G, Parize P, Caruba T, Bouvet A, Mainardi JL et al (2015) Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination. J Infect 71(2):200–206

    Article  Google Scholar 

  9. Roblot F, Besnier JM, Giraudeau B, Simonnard N, Jonville-Bera AP, Coipeau P et al (2007) Lack of association between rifampicin plasma concentration and treatment-related side effects in osteoarticular infections. Fundam Clin Pharmacol 21:363–369

    Article  CAS  Google Scholar 

  10. Vollmer NJ, Rivera CG, Stevens RW, Oravec CP, Mara KC, Suh GA et al (2021) Safety and tolerability of fluoroquinolones in patients with staphylococcal periprosthetic Joint Infections. Clin Infect Dis 73(5):850–856

    Article  CAS  Google Scholar 

  11. Mendes-Bastos P, Macedo R, Duarte R (2017) Treatment of hidradenitis suppurativa with rifampicin: have we forgotten tuberculosis? Br J Dermatol 177:e150–e151

    Article  CAS  Google Scholar 

  12. Jones RN, Mendes RE, Sader HS, Castanheira M (2011) In vitro antimicrobial findings for fusidic acid tested against contemporary (2008–2009) gram-positive organisms collected in the United States. Clin Infect Dis 52(Suppl 7):S477–S486

    Article  Google Scholar 

  13. Curbete MM, Salgado HR (2016) A critical review of the properties of fusidic acid and analytical methods for its determination. Crit Rev Anal Chem 46(4):352–360

    Article  CAS  Google Scholar 

  14. Minassian AM, Osmon DR, Berendt AR (2014) Clinical guidelines in the management of prosthetic joint infection. J Antimicrob Chemother 69(Suppl 1):i29-35

    Article  CAS  Google Scholar 

  15. Klein S, Nurjadi D, Eigenbrod T, Bode KA (2016) Evaluation of antibiotic resistance to orally administrable antibiotics in staphylococcal bone and joint infections in one of the largest university hospitals in Germany: is there a role for fusidic acid? Int J Antimicrob Agents 47(2):155–157

    Article  CAS  Google Scholar 

  16. Comité de l’antibiogramme de la Société Française de Microbiologie. European Committee on Antimicrobial Susceptibility Testing. Guidelines 2021 (April). https://www.sfm-microbiologie.org/wp-content/uploads/2021/04/CASFM2021__V1.0.AVRIL_2021.pdf. (accessed July 27th)

  17. Biswas M, Owen K, Jones MK (2002) Hypocalcaemia during fusidic acid therapy. J R Soc Med 95(2):91–93

    Article  CAS  Google Scholar 

  18. Bataillard M, Beyens MN, Mounier G, Vergnon-Miszczycha D, Bagheri H, Cathebras P (2019) Muscle damage due to fusidic acid-statin interaction: review of 75 cases from the French pharmacovigilance database and literature reports. Am J Ther 26(3):e375–e379

    Article  Google Scholar 

  19. Farrell DJ, Castanheira M, Chopra I (2011) Characterization of global patterns and the genetics of fusidic acid resistance. Clin Infect Dis 52(Suppl 7):S487-92

    Article  CAS  Google Scholar 

  20. Pushkin R, Iglesias-Ussel MD, Keedy K, MacLauchlin C, Mould DR, Berkowitz R et al (2016) A randomized study evaluating oral fusidic acid (CEM-102) in combination with oral rifampin compared with standard-of-care antibiotics for treatment of prosthetic joint infections: a newly identified drug-drug interaction. Clin Infect Dis 63(12):1599–1604

    Article  CAS  Google Scholar 

  21. Ertek M, Yazgi H, Erol S, Altoparlak U (2002) Demonstration of in vitro antagonism between fusidic acid and quinolones. J Int Med Res 30(5):525–528

    Article  CAS  Google Scholar 

  22. Siala W, Rodriguez-Villalobos H, Fernandes P, Tulkens PM, Van Bambeke F (2018) Activities of combinations of antistaphylococcal antibiotics with fusidic acid against staphylococcal biofilms in in vitro static and dynamic models. Antimicrob Agents Chemother 62(7):e00598-e618

    Article  CAS  Google Scholar 

  23. Hajikhani B, Goudarzi M, Kakavandi S, Amini S, Zamani S, van Belkum A et al (2021) The global prevalence of fusidic acid resistance in clinical isolates of Staphylococcus aureus: a systematic review and meta-analysis. Antimicrob Resist Infect Control 10(1):75

    Article  Google Scholar 

  24. Fink B, Sevelda F (2017) Periprosthetic joint infection of shoulder arthroplasties: diagnostic and treatment options. Biomed Res Int 2017:4582756

    Article  Google Scholar 

  25. Boisrenoult P (2018) Cutibacterium acnes prosthetic joint infection: diagnosis and treatment. Orthop Traumatol Surg Res 104(1S):S19–S24

    Article  CAS  Google Scholar 

  26. Hedlundh U, Zacharatos M, Magnusson J, Gottlander M, Karlsson J (2021) Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between Cutibacterium acnes infections and uncemented prostheses? J Bone Jt Infect 6(6):219–228

    Article  Google Scholar 

  27. Faber M, Rosdahl VT (1990) Susceptibility to fusidic acid among Danish Staphylococcus aureus strains and fusidic acid consumption. J Antimicrob Chemother 25(Suppl B):7–14

    Article  CAS  Google Scholar 

  28. Bernard L, Arvieux C, Brunschweiler B, Touchais S, Ansart S, Bru JP et al (2021) Antibiotic therapy for 6 or 12 weeks for prosthetic joint infection. N Engl J Med 384(21):1991–2001

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are indebted to Drs Saidou Diallo and Jean Charles Kleiber for their help while taking care of the patients.

Author information

Author notes

  1. Juliette Romaru and Anne Limelette contributed equally to this work. Delphine Lebrun and Morgane Bonnet contributed equally to this work.

Authors and Affiliations

  1. Service de Médecine Interne, Maladies Infectieuses Et Immunologie Clinique, Hôpital Robert Debré, Avenue du Général Koenig, 51100, Reims, France

    Juliette Romaru & Yohan N’Guyen

  2. Laboratoire de Bactériologie, Pôle de Biologie, 51100, Reims, France

    Anne Limelette & Véronique Vernet Garnier

  3. Service d’Orthopédie, Hôpital Maison Blanche, 51100, Reims, France

    Delphine Lebrun

  4. Pharmacie Hospitalière, Hôpital Robert Debré, 51100, Reims, France

    Morgane Bonnet

Authors
  1. Juliette Romaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne Limelette
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Delphine Lebrun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Morgane Bonnet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Véronique Vernet Garnier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yohan N’Guyen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JR, AL, DL, MB and YNG. The first draft of the manuscript was written by YNG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yohan N’Guyen.

Ethics declarations

Ethics approval

Data confidentiality was preserved throughout this internal study (Reims University Hospital GDPR register number RMR004-03072021), in accordance with the principles of the Declaration of Helsinki.

Consent to participate

The patients were not required to provide individual consent because of the retrospective and non-interventional nature of this study, in accordance with French legislation. No patient had previously objected to the further use of their medical data.

Consent for publication

Written consent was obtained from the two patients, whose cases had been reported as supplementary material.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary Figure 1

Susceptibility to Fusidic acid of the 39 significant Cutibacterium spp strains isolated on bone samples expressed as inhibition zone diameters (mm) using disk diffusion methods. (PNG 31 kb)

High resolution image (TIF 57 kb)

ESM 1

(DOCX 60 kb)

ESM 2

(DOCX 30 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Romaru, J., Limelette, A., Lebrun, D. et al. Fusidic acid in a tertiary hospital: an observational study focusing on prescriptions, tolerance and susceptibility of Staphylococcus and Cutibacterium spp. strains from bone samples. Eur J Clin Microbiol Infect Dis 41, 1107–1113 (2022). https://doi.org/10.1007/s10096-022-04469-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-022-04469-6

Keywords

Search

Navigation