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Antibiotic treatment of gram positive bone and joint

By Elizabeth S. R. Darley and Alasdair P. Macgowan


We have noted with interest the points made by Frippiat et al.1 and make the following comments. We have not stated that the newer quinolones should not be considered for treatment of Gram-positive bone and joint infec-tions. We agree that this group of antibiotics offers an attractive alternative to standard parenteral therapy because of their potency against Gram-positive pathogens and good bioavailability, but caution that the safety of the newer quinolones in long-term use is not yet established. There is a lack of clinical experience and data regarding long-term outcome with these agents treating chronic infections in man, compared with older fluoroquinolones. Quinolone resistance is increasing; the development of resistance to the new fluoroquinolones in Gram-positive organisms has been reported in a pharmacodynamic study,2 and Frippiat et al.1 also refer to a clinical case where resistance developed in one o

Topics: osteomyelitis, bone infections, joint infections, antibiotics, Gram-positive
Year: 2004
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