title: Chemotherapy of acute bone and joint infections.
abstract: A series of 72 cases of acute osteomyelitis and acute septic arthritis has been presented. Operative intervention was necessary in 71% of our cases. All patients were treated with antibiotics. The initial antibiotic treatment in 39% of the cases was a combination of trimethoprim and sulfamethoxazole (TMP/SMX). This combination gave the lowest average time for subsidence of general symptoms and local signs. Staphylococcus aureus was the causative organism in 87% of our cases. Streptococcus pyogenes and Pneumococcus were the other causative organisms. Over half of the S. aureus infections were resistant to penicillin but none were resistant to TMP/SMX. Considering the low toxicity, good clinical response, lack of bacterial resistance, presence of synergy and broad antibacterial spectrum, the use of TMP/SMX is recommended in acute pyogenic bone and joint infections.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus; D013290:Streptococcal Infections / Q000188:drug therapy; D013297:Streptococcus pyogenes; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014295:Trimethoprim; D013420:Sulfamethoxazole