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Antibiotics in the treatment of chronic staphylococcal osteomyelitis
Abstract:
Fourteen patients with chronic osteomyelitis were treated with oral penicillin, oxacillin, or cloxacillin at a dose of 5 gm/day, plus 0.5 gm of probenecid (Benemid) three or four times per day. Treatment was continued for 2 1/2 to six months. In ten patients, evidence of osteomyelitis disappeared and there has been no recurrence during follow-up periods varying from six months to 2 1/2 years. Significant hepatotoxicity was encountered in two patients; one similar patient, not in this series but receiving a similar regimen of antibiotic, developed leukipenia. Thus, patients with chronic osteomyelitis appear to benefit from such a therapeutic program, but they must be monitored closely for hepatic or hematologic toxicity.
Insights
Oral penicillin, oxacillin, or cloxacillin combined with probenecid effectively treated chronic osteomyelitis in ten patients. Close monitoring for liver or blood toxicity is essential during this antibiotic therapy.
Area of Science:
- Infectious Diseases
- Pharmacology
- Orthopedic Surgery
Background:
- Chronic osteomyelitis is a persistent bone infection often requiring prolonged treatment.
- Antibiotic resistance and treatment challenges necessitate exploring effective therapeutic regimens.
Purpose of the Study:
- To evaluate the efficacy and safety of oral penicillin, oxacillin, or cloxacillin combined with probenecid for chronic osteomyelitis.
- To assess the long-term outcomes and potential toxicities associated with this treatment protocol.
Main Methods:
- A cohort of fourteen patients with chronic osteomyelitis received oral antibiotics (penicillin, oxacillin, or cloxacillin) at 5 gm/day.
- Probenecid (0.5 gm) was administered three to four times daily for 2.5 to 6 months.
- Patients were monitored for clinical resolution of infection and for adverse effects, including hepatotoxicity and leukopenia.
Main Results:
- Ten out of fourteen patients showed complete resolution of osteomyelitis with no recurrence during follow-up periods ranging from 6 months to 2.5 years.
- Two patients experienced significant hepatotoxicity, and one patient in a similar regimen developed leukopenia.
- The therapeutic regimen demonstrated a favorable outcome in the majority of treated patients.
Conclusions:
- Oral antibiotic therapy with penicillin, oxacillin, or cloxacillin, in conjunction with probenecid, appears beneficial for chronic osteomyelitis.
- Close monitoring for hepatic and hematologic toxicity is crucial for patients undergoing this treatment regimen.