Long-term follow-up trial of oral rifampin-cotrimoxazole combination versus intravenous cloxacillin in treatment of chronic staphylococcal osteomyelitis.
Author(s): Euba G, Murillo O, Fernandez-Sabe N, Mascaro J, Cabo J, Perez A, Tubau F, Verdaguer R, Gudiol F, Ariza J
Affiliation(s): Infectious Diseases Department, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. geubuga@gmail.com
Publication date & source: 2009-06, Antimicrob Agents Chemother., 53(6):2672-6. Epub 2009 Mar 23.
Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
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.
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