Clindamycin combination treatment for the treatment of bone and joint infections caused by clindamycin-susceptible, erythromycin-resistant Staphylococcus spp

Diagn Microbiol Infect Dis. 2021 Jan;99(1):115225. doi: 10.1016/j.diagmicrobio.2020.115225. Epub 2020 Sep 28.

Abstract

The objective of this study was to evaluate the clinical outcomes and safety of clindamycin combination antibiotherapy for the treatment of erythromycin-resistant, lincosamide-susceptible bone and joint infections caused by Staphylococcus spp. Between January 2010 and September 2018, 46 patients with Staphylococcus spp. erythromycin-resistant, lincosamide-susceptible bone and joint infections were treated with clindamycin combination antibiotherapy for 6 to 12 weeks. The type of infection was prosthetic in 20 cases (43.5%), osteosynthetic device in 15 cases (32.6%), chronic osteomyelitis in 7 cases (15.2%), and arthritis in 4 cases (8.7%). The cure rate was 67.4% by intention to treat and 84.6% per protocol, with a median follow-up of 398 days (range 86-843). Only 2 relapses (5.1%) were observed in patients with chronic osteomyelitis; an acquired resistance to lincosamides developed in 1 case. Clindamycin combination therapy appears to be effective for the treatment of bone and joint infection caused by erythromycin-resistant, lincosamide-susceptible Staphylococcus spp.

Keywords: Bone infection; Clindamycin combination antibiotherapy; Clindamycin susceptible; Clindamycin–rifampicin; Erythromycin-resistant Staphylococcus; Staphylococcus spp..

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Arthritis, Infectious / drug therapy*
  • Arthritis, Infectious / microbiology
  • Bone and Bones / microbiology
  • Clindamycin / therapeutic use*
  • Drug Resistance, Bacterial / physiology
  • Drug Therapy, Combination
  • Erythromycin / pharmacology
  • Female
  • Humans
  • Joints / microbiology
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology
  • Rifampin / therapeutic use
  • Staphylococcal Infections / drug therapy*
  • Staphylococcus / drug effects
  • Staphylococcus aureus / drug effects

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Erythromycin
  • Rifampin