[Treatment of osteomyelitis with oral bactericidal antibiotics-- description of 9 cases]

The efficacy of oral bactericidal antibiotics in the treatment of osteomyelitis is analyzed retrospectively by a review of 9 cases histories. The first patient was treated in 1982. Clinical and laboratory controls were reviewed up to 1.1.1995. In 6 patients S. aureus was isolated, 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 prothesis. The isolated S. aureus were sensitive to the antibiotics prescribed. 8 patients received a combination of flucloxacillin (2-4 g/day) and rifampicin (600 mg/day); one patient was treated with the combination amoxicillin/clavulanic acid (1500/425 mg/day) followed by ofloxacin (400 mg/day) and finally co-trimoxazole (320/1600 mg/day). 3 patients received all antibiotics orally; in 6 patients oral administration followed a short intravenous course of the antibiotic combination. The duration of treatment varied between 6 and 23 weeks. Follow-up extended 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 penetration into bone tissue can be prescribed in selected cases of osteomyelitis to shorten or even avoid the standard intravenous therapy of acute or chronic diseases.