Experience with outpatient intravenous teicoplanin therapy for chronic osteomyelitis

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Abstract
Thirty-seven patients with acute exacerbations of chronic osteomyelitis caused by methicillin-susceptibleStaphylococcus aureus (n=13), methicillin-resistantStaphylococcus aureus (n=12), methicillin-susceptible coagulase-negative staphylococci (n=9), methicillin-resistant coagulase-negative staphylococci (n=1) and enterococci (n=2) were treated intravenously with teicoplanin. After a loading dose of 7 to 16 mg/kg (median 11 mg/kg) for 4 to 7 days, patients received 9 to 25 mg/kg (median 14 mg/kg) on Mondays, Wednesdays and Fridays in an outpatient setting to reach trough serum levels between 5 mg/l and 15 mg/l. The duration of treatment ranged from 28 to 150 days (median 60 days). Cure was obtained in 14 (38 %) and improvement in 17 (46 %) cases, and failure was observed in 6 (16 %) patients. Adverse effects occurred in 6 patients, and caused discontinuation of treatment in 3 patients. The financial savings exceeded US$60,000 per patient compared with the high hospitalization costs of inpatient treatment.