Treating bone and joint infections


Intravenous literature: Zeller, V., Dzeing-Ella, A., Kitzis, M.D., Ziza, J.M., Mamoudy, P. and Desplaces, N. (2010) Continuous clindamycin infusion, an innovative approach to treating bone and joint infections. Antimicrobial Agents & Chemotherapy. 54(1), p.88-92.


The feasibility, safety, and efficacy of prolonged, continuous, intravenous clindamycin therapy were retrospectively evaluated for 70 patients treated for bone and joint infections, 40% of whom were treated as outpatients. The median treatment duration was 40 days, the median daily clindamycin dose was 2,400 mg, and three moderate-grade adverse events occurred. The median serum clindamycin concentrations on days 3 to 14 and days 8 to 28 were 5 and 6.2 mg/liter, respectively; the median concentration was significantly lower (P < 0.02) in patients treated with rifampin (5.3 mg/liter) than in those not treated with rifampin (8.9 mg/liter). Among 53 patients with a median follow-up of 30 months (range, 24 to 53 months), 49 (92%) were considered cured (1 patient had a relapse, and 3 patients had reinfections).


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