JAC Advance Access published online on April 29, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh191
© 2004 by The British Society for Antimicrobial Chemotherapy
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Bristol Centre for Antimicrobial Research and Evaluation,
Southmead Hospital,
Westbury-on-Trym, Bristol BS10 5NB, UK
* To whom correspondence should be addressed. E-mail: elizabeth.darley{at}north-bristol.swest.nhs.uk.
Gram-positive organisms, particularly staphylococci
and streptococci, are responsible for the majority of bone and joint
infections. Treatment of these infections can be difficult, usually
involving a prolonged course of antibiotics, often with surgical
intervention. The selection of antibiotics depends on sensitivity profile,
patient tolerance and long-term goals, e.g. cure or suppression,
but there are few randomized controlled trials in patients comparing
efficacy of different antibiotics. Different degrees of bone penetration
and clinical outcome for specific antibiotics, e.g. the
Revised February 17, 2004
Accepted February 18, 2004
Review
Antibiotic treatment of Gram-positive bone and
joint infections
Abstract 
-lactams,
clindamycin and quinolones, have been described, although the methodology
in these studies is not standardized and findings cannot always
be applied directly to patients. The effect of attaining minimum
serum bactericidal concentrations in patients has also been studied
but this is no longer routinely recommended in clinical practice.
Comparative clinical trials are few but have demonstrated efficacy
of oral fluoroquinolones in combination with either rifampicin or
fusidic acid for selected Gram-positive infections. In the past
decade, increasingly resistant organisms, e.g. methicillin-resistant Staphylococcus aureus and vancomycin-resistant
enterococci have been recognized as causes of orthopaedic infection.
Individual case reports describe successful treatment using the
newer antibiotics, e.g. linezolid and quinupristin/dalfopristin,
but results of clinical trials are awaited.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Meehan, A. A. Jamali, and H. Nguyen Prophylactic Antibiotics in Hip and Knee Arthroplasty J. Bone Joint Surg. Am., October 1, 2009; 91(10): 2480 - 2490. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. G. Solon, J. A. Dowell, J. Lee, S. P. King, and B. D. Damle Distribution of Radioactivity in Bone and Related Structures following Administration of [14C]Dalbavancin to New Zealand White Rabbits Antimicrob. Agents Chemother., August 1, 2007; 51(8): 3008 - 3010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. S. Kuehnel, C. Schurr, K. Lotter, and F. Kees Penetration of telithromycin into the nasal mucosa and ethmoid bone of patients undergoing rhinosurgery for chronic sinusitis J. Antimicrob. Chemother., April 1, 2005; 55(4): 591 - 594. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. McNamara and J. M. Steckelberg Vancomycin J. Am. Acad. Ortho. Surg., March 1, 2005; 13(2): 89 - 92. [Full Text] [PDF]
|
|
|
|
|
|
M. Bassetti, F. Vitale, G. Melica, E. Righi, A. Di Biagio, L. Molfetta, F. Pipino, M. Cruciani, and D. Bassetti Linezolid in the treatment of Gram-positive prosthetic joint infections J. Antimicrob. Chemother., March 1, 2005; 55(3): 387 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Whitehouse, J. A. Cepeda, R. Shulman, L. Aarons, R. Nalda-Molina, C. Tobin, A. MacGowan, S. Shaw, C. Kibbler, M. Singer, et al. Pharmacokinetic studies of linezolid and teicoplanin in the critically ill J. Antimicrob. Chemother., March 1, 2005; 55(3): 333 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Frippiat, F. Meunier, and G. Derue Place of newer quinolones and rifampicin in the treatment of Gram-positive bone and joint infections J. Antimicrob. Chemother., December 1, 2004; 54(6): 1158 - 1158. [Full Text] [PDF]
|
|