[Oral antibiotic therapy in the adult bacterial osteomyelitis: results after two years of follow-up]

Abstract

Background: Oral antibiotic therapy achieves clinical and bacteriological cure of the adult bacterial osteomyelitis associated or not to orthopedic implant.

Patients and methods: We carried out a prospective study, with follow-up at 24 months, of patients with adult bacterial osteomyelitis, that were initially treated with parenteral antibiotic therapy for a week, followed with oral antibiotic therapy during 2 to 6 months, depending on the absence or presence or orthopedic implant, respectively.

Results: 37 patients presented 44 episodes of adult bacterial osteomyelitis, 34 of them in presence of orthopedic implant. The most frequent causative microorganism was S. aureus (44%), followed by coagulase-negative Staphylococcus (29%). The oral antibiotic therapy most frequently employed was the combination cotrimoxazole-rifampin, followed by ciprofloxacin-rifampin. The clinical and bacteriologic cure were 85%, 82% in the group with orthopedic implant. 82% required surgical intervention.

Conclusions: The oral antibiotic therapy, preceded by a short parenteral therapy, can get high rates of clinical and bacteriological cure in the adult's bacterial osteomyelitis.