Long-term intramuscular teicoplanin treatment of chronic osteomyelitis dueto oxacillin-resistant Staphylococcus aureus in outpatients

Oxacillin-resistant staphylococci are the most serious pathogens in chronic osteomyelitis and only glycopeptides have been shown to be efficacious aga inst them. We assessed the safety and efficacy of a regimen of teicoplanin 400 mg/day i.m, as long-term treatment in outpatients with osteomyelitis. A total of 76 patients received teicoplanin. Twenty-five patients had chroni c prosthetic osteomyelitis (20 hip) and 51 patients had osteomyelitis cause d by osteo-synthesis devices. Oxacillin-resistant Staphylococcus aureus was isolated in pure culture in 55 patients (72%). A total of 21 patients had polymicrobial infection with a total of 48 isolated strains. All patients w ere treated with teicoplanin 400 mg i.m. once-a-day alone or with other dru gs for a minimum of 4 months, Only one patient had side effects requiring d iscontinuation of treatment, The teicoplanin dose was reduced to 200 mg/day i.m. in 2 patients to decrease creatinine clearance values. Seventy out of 76 patients were cured.