title: Prolonged treatment of chronic Pseudomonas aeruginosa osteomyelitis with a combination of two effective antibiotics.
abstract: Emergence of Pseudomonas aeruginosa resistant to antibiotic monotherapy is one of the causes of therapeutic failure in chronic P. aeruginosa osteomyelitis. We report 15 cases of chronic (> 3 months of evolution) biopsy culture proven P. aeruginosa osteomyelitis included in an open prospective study evaluating the efficacy of prolonged treatment (> 4 months) with two effective antibiotics in combination. Mean post-treatment follow-up was 38 months. A regimen of cefsulodin in combination with oral ofloxacin was used for six patients, cefsulodin-pefloxacin for three patients, cefsulodin-ciprofloxacin for one patient, piperacillin-pefloxacin for one patient, cefsulodin-fosfomycin for one patient, imipenem-ciprofloxacin for two patients and amoxicillin-ciprofloxacin-fosfomycin for one patient as home therapy. The clinical cure rate of 73% and bacteriological cure rate of 93% are far superior to those previously described in the literature. We did not observe adverse drug reactions. We think that a prolonged use of two effective antibiotics in combination is a safe and improved therapeutic schedule for chronic P. aeruginosa osteomyelitis.
authors.affiliation: Dept. of Infectious Diseases, Hopital de Bellevue, Centre Hospitalier Universitaire, Saint-Etienne, France.
authors.forename: R F
authors.initials: RF
authors.lastname: Lucht
authors.forename: A
authors.initials: A
authors.lastname: Fresard
authors.forename: P
authors.initials: P
authors.lastname: Berthelot
authors.forename: F
authors.initials: F
authors.lastname: Farizon
authors.forename: G
authors.initials: G
authors.lastname: Aubert
authors.forename: G
authors.initials: G
authors.lastname: Dorche
authors.forename: G
authors.initials: G
authors.lastname: Bousquet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D001706:Biopsy; D002908:Chronic Disease; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents