[Teicoplanin in the treatment of bone and joint infections due to methicillin resistant staphylococci. Experience in adult patients].
We retrospectively evaluated 89 episodes of bone and joint infections due to methicillin-resistant staphylococci: 56 chronic osteomyelitis (CO), 10 septic arthritis (SA) and 23 infections associated to arthroplasties (IAA). We analyzed the efficacy of Teicoplanin (T) in three times a week or daily administration schemes and adequate surgery (AS). Also, we determined cost savings derived from outpatient parenteral antibiotic therapy (OPAT). The overall efficacy of T in CO and both in cases with and without implants, was higher when antibiotic therapy was associated to AS (86 vs. 46%, p = 0.001; 100 vs. 33%, p = 0.0049 and 76 vs. 50%, p = 0.09). All SA were cured. The overall efficacy of T was higher in IAA with implant removal vs. surgical debridement (100 vs. 54%, p = 0.045). In all cases, T was similarly effective when administered three times a week vs. daily administration, when associated to AS. The savings derived from OPAT were 897 days/bed and USS 179,400. Adverse effects were few and light (8 episodes, 9%). The results obtained are similar to those published in the literature and show that T administered daily or in a three times a week scheme and associated to AS, is effective and safe for the treatment of bone and joint infections. The savings derived from OPAT, mainly related to reduced hospitalization, are significant in these pathologies, which usually require long treatment periods.
Pensotti
Claudia
C
Fundación del Centro de Estudios Infectológicos (FUNCEI), French 3037, 1425 Buenos Aires, Argentina.
Nacinovich
Francisco
F
Vidiella
Gabriela
G
Carbone
Edith
E
Marin
Marcelo
M
Di Stéfano
Carlos
C
Stamboulian
Daniel
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy; D001178:Arthroplasty / Q000009:adverse effects; D001850:Bone Diseases, Infectious / Q000188:drug therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000188:drug therapy*; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D017334:Teicoplanin / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017334:Teicoplanin