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Antimicrobial Agents and Chemotherapy, June 2009, p. 2672-2676, Vol. 53, No. 6
0066-4804/09/$08.00+0     doi:10.1128/AAC.01504-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Long-Term Follow-Up Trial of Oral Rifampin-Cotrimoxazole Combination versus Intravenous Cloxacillin in Treatment of Chronic Staphylococcal Osteomyelitis{triangledown}

G. Euba,1* O. Murillo,1 N. Fernández-Sabé,1 J. Mascaró,1,{dagger} J. Cabo,2 A. Pérez,2 F. Tubau,3 R. Verdaguer,3 F. Gudiol,1 and J. Ariza1

Infectious Diseases Department,1 Orthopedic Surgery Department,2 Microbiology Department, IDIBELL, Hospital Universitari de Bellvitge, Barcelona, Spain3

Received 10 November 2008/ Returned for modification 2 February 2009/ Accepted 16 March 2009

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.

* Corresponding author. Mailing address: Infectious Diseases Department, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. Phone: 34 93 260 7625. Fax: 34 93 260 7637. E-mail: geubuga{at}gmail.com

{triangledown} Published ahead of print on 23 March 2009.

{dagger} Present address: Internal Medicine Department, Hospital Mútua de Terrassa, Plaça Doctor Robert, 08221 Terrassa, Barcelona, Spain.

Antimicrobial Agents and Chemotherapy, June 2009, p. 2672-2676, Vol. 53, No. 6
0066-4804/09/$08.00+0     doi:10.1128/AAC.01504-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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