JAC Advance Access published online on March 28, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg186
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original Article
1 Infections Limited, P.S.,
Tacoma, WA
* Corresponding author. E-mail: alantice{at}idlinks.com.
Received 15 July 2002
; revised 8 November 2002
; accepted 3 February 2003
Outcome indicators of recurrence and amputation were
used to evaluate risk factors and treatment choices in 454 patients
with osteomyelitis who completed outpatient parenteral antimicrobial
therapy (OPAT). Three hundred and fifteen (69.4%) were
apparently cured at the time outcomes were measured and 139 (30.6%)
had a recurrence. Of the recurrences, 56% occurred within
3 months, 78% within 6 months and 95% within 1
year. Both the initial pathogen and the choice of antibiotic had
an effect on the risk of treatment failure. Osteomyelitis caused
by Pseudomonas aeruginosa was associated with more
than a two-fold increase in recurrence (P = 0.005)
compared with infection caused by Staphylococcus aureus. There
was a positive correlation between P. aeruginosa and
amputation. With S. aureus infections, the risk
of recurrence was more than twice as great with vancomycin therapy
as opposed to treatment with
Keywords: osteomyelitis, outcomes
Risk factors and treatment outcomes in osteomyelitis
2 OPAT Outcomes
Registry, Tacoma, WA
3 PPD
Development,
Wilmington, NC; Department
of Epidemiology, University of Washington, Seattle, WA, USA
-lactams
(P = 0.03). Treatment with ceftriaxone
was as effective as the penicillinase-resistant penicillins and
cefazolin.
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