Cefsulodin Therapy for Osteomyelitis Due to Pseudomonas aeruginosa

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Abstract
The results of treating chronic Pseudomonas aeruginosa osteomyelitis with cefsulodin at Rush-Presbyterian-St. Luke's Medical Center (RPSLMC) and eight other institutions are summarized. Eleven patients whose infections were proven by bone-biopsy culture were treated with cefsulodin at RPSLMC; one received two courses of treatment. Efficacy of therapy was evaluated for eight patients, all of whom had a polymicrobial infection. The average age of the patients was 52.3 years (range, 28–85). All had serious underlying illnesses or associated conditions. The mean inhibitory concentration of cefsulodin for the isolates of P. aeruginosa was 3.125 µg/rnl (range, 0.78–6.25 µg/ml). Two patients received concomitant therapy with antibiotics not active against P. aeruginosa. Surgical debridement was performed in six of the eight patients. A favorable response was demonstrated in six of the eight patients. Follow-up for seven patients ranged from one week to 12 months, and in the eighth patient follow-up was 32 months. One patient relapsed twice. Seven possible complications of therapy were observed in five of the 11 patients who received cefsulodin; in three of these patients cefsulodin had to be discontinued. In studies of osteomyelitis conducted at other institutions, 10 of 14 patients for whom therapy could be evaluated had a favorable response to cefsulodin. Cefsulodin is a useful agent for the treatment of chronic osteomyelitis associated with P. aeruginosa.

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