Low-dose clindamycin viable for non-S. aureus prosthetic joint infection

This retrospective cohort offers real-world outcome data for clindamycin 300 mg three times daily as a second-line oral backbone in prosthetic joint infection, including in combination with rifampicin despite a documented pharmacokinetic interaction.

clindamycinrifampicinlincosamidesprosthetic joint infectionStaphylococcus aureusCutibacterium acnescoagulase-negative staphylococcistreptococciDAIRretrospective cohortantimicrobial stewardshipIV-to-oraldrug interaction Infectious Disease / Antimicrobials

Background Information

Clindamycin is effective for prosthetic joint infections, though less so for Staphylococcus aureus.

Prosthetic joint infections (PJIs) are challenging to treat due to the risk of recurrence and antibiotic resistance. Evaluating the effectiveness of clindamycin offers insights for alternative therapies. Clindamycin achieved an 82% overall success rate over two years. Success was highest in two-stage exchange (94%), with increased side effects when combined with rifampicin (39% vs 10%). The study suggests clindamycin as a viable option when first-line treatments are unsuitable, but it may be less effective against Staphylococcus aureus. Retrospective nature limits generalizability. Clindamycin shows promise for PJI treatment but may be less effective against Staphylococcus aureus.

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Authors: Ericsson J, Gustafsson T, Sköldenberg O, Hedenstierna M, Rysinska A, Ursing J

Citation: Ericsson J, Gustafsson T, Sköldenberg O, et al. Effectiveness and tolerability of low dose clindamycin for treatment of prosthetic joint infections, a retrospective cohort study. BMC infectious diseases. 2026;26(1). doi:10.1186/s12879-026-14378-0

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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