Ceftriaxone treatment of multidrug-resistant Salmonella osteomyelitis.
Empiric treatment of serious Salmonella infections has been complicated by the emergence of strains resistant to multiple antimicrobial agents, including ampicillin, chloramphenicol, and trimethoprim/sulfamethoxazole. Recent reports suggest that the third-generation cephalosporins may be effective therapy for Salmonella infections. This report describes a case of antibiotic-resistant Salmonella heidelberg prosthetic hip infection successfully treated with prosthesis removal and once-daily ceftriaxone. Tube dilution sensitivity testing of the organism demonstrated minimal inhibitory and minimal bactericidal concentrations of 0.12 microgram/ml. Serum bactericidal activity, 30 minutes after infusion, was inhibitory and bactericidal at 1:512. It is concluded that the favorable preliminary results reported in the literature and the outcome in this patient suggest that the third-generation cephalosporins may be effective therapy for Salmonella infections and should undergo clinical trials.
D000328:Adult; D002443:Ceftriaxone / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D011475:Prosthesis Failure; D012475:Salmonella / Q000187:drug effects / Q000302:isolation & purification; D012480:Salmonella Infections / Q000188:drug therapy* / Q000382:microbiology
D002443:Ceftriaxone