The use of artificial joint replacements can considerably improve the quality of life of patients suffering from arthritis. Unfortunately, about 1-2% of joint replacements get infected after surgery. Treatment of joint replacement infections can be difficult and usually involves both surgery and antibiotic treatment.
When someone has an infection, the bacteria involved can stick to the metal used in the replacement joint, forming a “biofilm” or layer of bacteria on the surface. It is thought that treatment of these infections should include antibiotics that can break into the biofilm. One such antibiotic is rifampicin.
However, sometimes rifampicin cannot be used, for example due to antibiotic resistance stopping it having an effect or side effects. It has been suggested in some medical guidelines that infected joint replacements should be removed when this happens as they predict without rifampicin the replacement cannot be saved, and that the only option is to start again with a new replacement. However, in Oxford many patients have been treated without rifampicin and it appears that this has been successful for some patients even without removal of the replacement. We want to learn more about how effective treatment without rifampicin is.