TREATMENT OF OSTEOMYELITIS WITH ORAL BACT ERICIDAL ANTIBIOTICS - OUR EXPERIENCE WITH 9 PATIENTS

The efficacy of oral bactericidal antibiotics in the treatment of oste omyelitis is analyzed retrospectively by a review of 9 case histories. The first patient was treated in 1982. Clinical and laboratory contro ls were reviewed up to 1. 1. 1995. In 6 patients S., aureus was isolat ed, while in 3 patients the organism could not be cultured but gram cocci were almost likely. 5 cases of osteomyelitis were acute, 4 were chronic and in one case there was an infection of an artificial knee p rothesis. The isolated S. aureus were sensitive to the antibiotics pre scribed. 8 patients received a combination of flucloxacillin (2-4 g/da y) and rifampicin (600 mg/day); one patient was treated with the combi nation amoxicillin/clavulanic acid (1500/425 mg/day) followed by oflox acin (400 mg/day) and finally co-trimoxazole (320/1600 mg/day). 3 pati ents received all antibiotics orally; in 6 patients oral administratio n followed a short intravenous course of the antibiotic combination. T he duration of treatment varied between 6 and 23 weeks. Follow-up exte nded over 9 months (n = 1), 14 months (n = 3), 4-7 years (n = 3), and 10-12 years (n = 2). In 8 cases the osteomyelitis was cured (89%). In our view, a combination of bactericidal oral antibiotics with good pen etration into bone tissue can be prescribed in selected cases of osteo myelitis to shorten or even avoid the standard intravenous therapy of acute or chronic diseases.