Long-term follow-up trial of oral rifampin-cotrimoxazole combination versus intravenous cloxacillin in treatment of chronic staphylococcal osteomyelitis.
Oral therapies alternative to fluoroquinolones against staphylococcal chronic osteomyelitis have not been evaluated in comparative studies. Consecutive nonaxial Staphylococcus aureus chronic osteomyelitis cases were included in a comparative trial after debridement. Fifty patients were randomized: group A (n = 22) was treated with cloxacillin for 6 weeks intravenously plus 2 weeks orally (p.o.), and group B (n = 28) was treated with rifampin-cotrimoxazole for 8 weeks p.o. During follow-up (10 years), five relapses occurred: two (10%) in group A and three (11%) in group B. Foreign-body maintenance was associated with relapse (P = 0.016). Oral rifampin-cotrimoxazole treatment showed outcomes comparable to those for intravenous cloxacillin treatment.
Euba
G
G
Infectious Diseases Department, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. geubuga@gmail.com
Murillo
O
O
Fernández-Sabé
N
N
Mascaró
J
J
Cabo
J
J
Pérez
A
A
Tubau
F
F
Verdaguer
R
R
Gudiol
F
F
Ariza
J
J
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003023:Cloxacillin / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy; D012293:Rifampin / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000188:drug therapy*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*
D000890:Anti-Infective Agents; D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003023:Cloxacillin; D012293:Rifampin