[Treatment of osteoarticular infections with clindamycin in adults]

Author(s): El Samad Y, Havet E, Bentayeb H, Olory B, Canarelli B, Lardanchet JF, Douadi Y, Rousseau F, Lescure FX, Mertl P, Eb F, Schmit JL

Affiliation(s): Service de maladies infectieuses et tropicales, hopital Nord, CHU d'Amiens, place Victor-Pauchet, Amiens cedex, France. elsamad.youssef@chu-amiens.fr

Publication date & source: 2008-09, Med Mal Infect., 38(9):465-70. Epub 2008 Aug 20.

Publication type: English Abstract

The main characteristics of clindamycin are adequate for treatment of osteoarticular infections (OAI): good bone diffusion, broad spectrum of antibacterial activity and oral use. METHOD: A number of 61 patients was included in an observational retrospective study of efficacy and tolerance. RESULTS: Prosthetic infections accounted for 50.8% of the cases and chronic osteitis for 36.1%. The causative micro-organisms were Staphylococci (72.2%) and Streptococci (15.3%); 86.5% of these strains were susceptible to erythromycin, 9.6% were erythromycin resistant and susceptible to lincomycin. Clindamycin was associated with either ofloxacine, rifampicin, or teicoplanin in 88.5% and the average course duration was 101 days. A surgical procedure was performed in 84% of cases. Complete cure was obtained in 91.1% at 18 months of follow up. Only one cutaneous rash and one Clostridium difficile-associated diarrhea occurred. The other adverse effects were gastrointestinal in 36%, cutaneous in 6.6%, and hematological in 1.6%, but did not lead to discontinuation of therapy. CONCLUSION: Clindamycin can be used in OAI in association with or as an alternative to rifampicin, fluoroquinolones, or glycopeptides according to microbiological data.