Teicoplanin treatment for bone and joint infections

Severe bone and joint infections require a first step intravenous antibiotic treatment, sometimes leading to prolonged hospitalization. Teicoplanin diffuses well in bones, is efficient on bacteria involved in bone and joint infections, can be prescribed once a day, and is well tolerated. These features lead the authors to use teicoplanin for 112 episodes of severe bone and joint infections in 110 patients. Infection was due to a prosthetic device in 69 cases. It was chronic in 22 cases and acute in 21 cases. S. aureus was isolated in 72 patients and a coagulase negative staphylococci in 33 cases. 64 strains were methicillin resistant. 91 % of the patients were considered as cured at the end of the treatment and 80 % 17 months later at follow-up. Teicoplanin tolerance was good with side effect in only 11 % of the cases (never severe enough for treatment interruption). For some patients, hospital stay was shortened by using ambulatory teicoplanin treatment. This lowered treatment cost and favored compliance.