tedizolid and Osteomyelitis

Dalbavancin is a new antibiotic against multi-drug resistant Gram (+) bacteria. Dalbavancin has an extremely long half-life. Current indication is skin and soft tissue infections (ABSSSI), but researchers have successfully administered it off-label to osteomyelitis (OM) patients.. We present a case of successful treatment of diabetic foot (DF) OM.. A 53-year-old male presented to our DF clinic, with recently diagnosed diabetes mellitus, with very bad glycaemic control (HbA1c=12,5%). He had diabetic neuropathy, but no peripheral arteriopathy. Two months before, because of an accident with hot water, he presented left foot ulcer, followed by ABSSSI and 1. Dalbavancin, due to its extremely long half-life, could potentially be the drug of choice for OM caused by multi-drug resistant Gram (+) cocci, in order to avoid hospitalization, especially on non-complient patients. Further research is necessary.

Topics: Anti-Bacterial Agents; Burns; Daptomycin; Diabetes Mellitus, Type 2; Diabetic Foot; Drug Resistance, Multiple, Bacterial; Enterococcus faecium; Gram-Positive Bacterial Infections; Humans; Linezolid; Male; Middle Aged; Osteomyelitis; Oxazolidinones; Teicoplanin; Tetrazoles; Tigecycline

Despite the advances in current healthcare, bone and joint infections (BJIs) are a major clinical challenge that frequently involve prolonged systemic antibiotic use. Healthcare providers consider tedizolid an attractive candidate for therapy in adults and children with BJI.. We tested tedizolid against a US and European collection of Gram-positive BJI isolates (n = 797) consecutively collected from 2014 to 2017.. Organisms were tested by broth microdilution susceptibility methods following current CLSI guidelines and interpreted by both CLSI and EUCAST breakpoint criteria.. Staphylococcus aureus (59.3%; 58.6% in the USA and 60.4% in Europe) was the most common pathogen with a 29.6% MRSA rate and tedizolid MIC50/90 of 0.12/0.25 mg/L (100% susceptible). CoNS (15.0% of BJI in adults and <5% in children) had tedizolid MIC50/90 values of 0.12/0.12 mg/L (99.1% susceptible). Tedizolid exhibited MIC50/90 values of 0.12/0.25 mg/L for all streptococci and enterococci. Overall, high susceptibility rates (>95%) for vancomycin, daptomycin and linezolid were observed and, based on MIC90 values, tedizolid (MIC90 0.12-0.25 mg/L) was 4- to 8-fold more potent than linezolid (MIC90 0.5-2  mg/L) against this collection of Gram-positive pathogens causing BJI.. This study showed that tedizolid had potent in vitro activity against contemporary Gram-positive cocci causing BJI in adults and children in US and European hospitals.

Topics: Anti-Bacterial Agents; Arthritis, Infectious; Europe; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Osteomyelitis; Oxazolidinones; Tetrazoles; United States