Three-times weekly teicoplanin in the outpatient treatment of acute methicillin-resistant staphylococcal osteomyelitis: a pilot study.

Abstract

Treatment of osteomyelitis requires prolonged hospital stay, lengthy antibiotic therapy and adequate surgical debridement. Outpatient parenteral antibiotic therapy (OPAT) is a new approach to reduce patient discomfort and hospital costs. Teicoplanin, a glycopeptide antibiotic with a long half-life (72 hours), is one of the most useful drugs for OPAT. We performed a pilot study to assess the safety and efficacy of three-times weekly teicoplanin in the treatment of methicillin-resistant (MR) acute staphylococcal osteomyelitis. Ten patients with acute post-traumatic osteomyelitis were enrolled. Pathogens were MR Staphylococcus aureus (5 patients) and MR coagulase-negative staphylococci (5 patients). After a loading dose of 400 mg b.i.d. for 3 days, patients were treated with an intravenous dose of 1000 mg on Mondays and Wednesdays and with a 1200 mg dose on Fridays. Teicoplanin trough levels were maintained within a 10 to 20 mg/L range. If hardware removal had been possible at enrollment, treatment was carried out for at least 4 weeks. If, on the contrary, hardware removal had not been possible, teicoplanin was administered as suppressive therapy until hardware removal. Treatment was successfully performed in 9 out of 10 patients, whereas in one patient only improvement was achieved. Side effects were not recorded. Three times weekly teicoplanin seems to be a valuable option in the treatment of acute MR staphylococcal osteomyelitis. Further studies are warranted in order to better define the role of this new administration schedule in this field.

• Authors: L Lazzarini, A Tramarin, L Bragagnolo, G Tositti, V Manfrin, Lalla F de
• Journal: Journal of chemotherapy (Florence, Italy) (J Chemother) Vol. 14 Issue 1 Pg. 71-5 (Feb 2002) ISSN: 1120-009X [Print] England
• PMID: 11892903 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Teicoplanin

Topics

• Acute Disease
• Adult
• Aged
• Anti-Bacterial Agents (administration & dosage)
• Cost Savings
• Drug Administration Schedule
• Female
• Humans
• Male
• Methicillin Resistance
• Middle Aged
• Osteomyelitis (drug therapy)
• Outpatients
• Pilot Projects
• Staphylococcal Infections (drug therapy)
• Teicoplanin (administration & dosage)