The treatment of bone infections with ceftazidime

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Abstract
Twenty-one patients aged from 20 to 76 years (mean age 43.2 years old) (3 females and 18 males) suffering from bone infection were treated with ceftazidime. All had post-operative or post-traumatic infections and 14 had chronic infections. In 14 patients, the infection was caused by one organism, while the remaining 7 had mixed infections. In 9 patients the infection was severe, in 11 moderate and one mild. Ceftazidime was given by intravenous infusion over a period of 10 min in the majority of patients. Ten patients received 2 g three times daily to start, in 4 the dose was reduced to 1 g three times daily when the organism was eradicated. Eleven patients were treated with 1 g three times daily. The duration of treatment varied from 9 to 56 days, with a mean of 34.2 days. In 15 patients, surgery was performed for evacuation of pus or removal of a sequestrum. Eighteen patients out of 21 were cured, one patient improved, and two failed to respond to therapy. In 2 cases, relapse occurred within 12 days after treatment stopped with ceftazidime and in 2 patients Pseudomonas maltophilia was isolated during treatment. However, in both cases, this organism disappeared without any treatment 2 weeks after ceftazidime treatment was stopped. Tolerance was excellent and no side-effects were reported. Analysis of the haematological and biochemical tests performed before and after treatment showed no abnormalities except a transient elevation of liver enzymes in 2 patients and in 4 cases direct Coombs test became positive during treatment. In two cases the Coombs test became negative during the test period. In the remaining cases, direct Coombs' test became negative during follow-up.

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