TY - JOUR
TI - Chronic osteomyelitis caused by multi-resistant Gram-negative bacteria:
evaluation of treatment with newer quinolones after prolonged follow-up
AU - Galanakis, N
AU - Giamarellou, H
AU - Moussas, T
AU - Dounis, E
JO - The Journal of antimicrobial chemotherapy
PY - 1997
VL - 39
TODO - 2
SP - 241-246
PB - Oxford University Press
SN - null
TODO - 10.1093/jac/39.2.241
TODO - null
TODO - We evaluated ciprofloxacin, ofloxacin and pefloxacin regimens for the
treatment of chronic osteomyelitis due to Gram-negative multiresistant
organisms. The study was open, nonrandomized and included 28, 21 and 16
patients, respectively. The 4-fluoroquinolone regimens were 1000 mg, 400
mg and 400-800 mg bd, for a mean duration of 137, 163 and 134 days,
respectively. Pseudomonas aeruginosa was the most common pathogen,
isolated in 33 individuals. Patients were followed clinically,
bacteriologically and radiologically during treatment and for 2-5 years
after discontinuation of therapy. Clinical outcome at the end of therapy
was successful in 79%, 81% and 75%, improvement occurred in 11%,
10% and 19%, and the failure rate was 11%, 10% and 6%, while 11%,
5% and 6% relapsed, respectively. At the end of follow-up the
bacterial eradication rate was 68%, 76% and 69%, respectively.
Fluoroquinolone resistance emerged in 18%, 19% and 13% of
ciprofloxacin, ofloxacin and pefloxacin recipients, respectively. The
newer quinolones were safe and well tolerated and should be considered
as the contemporary treatment of choice for chronic Gram-negative
osteomyelitis, particularly whenever P. aeruginosa is implicated.
ER -