Ceftazidime as single-agent therapy for gram-negative aerobic bacillary osteomyelitis

The cases of 28 patients who received ceftazidime as single-agent therapy in prospective clinical trials for biopsy culture-proven osteomyelitis were reviewed. These cases all involved infection caused by gram-negative aerobic bacilli, the most frequent agent (83% of patients) being Pseudomonas aeruginosa. Posttreatment follow-up for patients with acute osteomyelitis was continued for at least 6 months, while follow-up for at least 12 months was done for patients with chronic osteomyelitis. A regimen of 2 g of ceftazidime intravenously every 12 h was used for most patients. The overall cure rates were 77% (acute disease) and 60% (chronic disease). Development of resistance to ceftazidime was not problematic, and the drug was well tolerated. Ceftazidime is effective for serious gram-negative bacillary osteomyelitis, including that due to P. aeruginosa. The twice-daily regimen did not cause major organ toxicity, eliminating the need for concentration monitoring and making it feasible to use the drug for home parenteral therapy.