University of Georgia College of Pharmacy, 1000 Jefferson Street, Albany, GA 31701, USA.
Downtown Dublin Wound Center, Meadows Regional Medical Center, Dublin, GA 31021, USA.
Int J Antimicrob Agents. 2019 Apr;53(4):429-434. doi: 10.1016/j.ijantimicag.2018.11.023. Epub 2018 Dec 8.
Osteomyelitis remains difficult to treat, typically requiring a prolonged course of intravenous (i.v.) antibiotics. The optimal route and duration of antibiotics remains ill-defined due to limited prospective clinical trials. Oritavancin is a long-acting, semisynthetic lipoglycopeptide antibiotic with rapid concentration-dependent bactericidal activity against many Gram-positive organisms. Favourable pharmacokinetics makes oritavancin an appealing alternative to currently available antibiotics requiring daily infusion to decrease the risk of vascular access complications associated with outpatient antimicrobial therapy. The purpose of this study was to report the outcomes of nine patients with chronic osteomyelitis receiving multidose oritavancin. Using electronic medical records, patients aged ≥18 years treated with i.v. oritavancin between September 2015 and April 2018 at Downtown Dublin Wound Center, a hospital-owned outpatient wound care clinic and infusion centre affiliated with Meadows Regional Health System in Dublin, GA, were identified. Of 12 cases reviewed, 9 patients received at least two doses of i.v. oritavancin for the treatment of chronic osteomyelitis. All nine patients experienced clinical cure at 6-month follow-up after the last dose of oritavancin. Multidose oritavancin was found to be a safe and efficacious option for chronic osteomyelitis when treatment options are limited by patient complexities or barriers in their ability to access healthcare services.
骨髓炎的治疗仍然具有挑战性，通常需要长期静脉（i.v.）使用抗生素。由于缺乏前瞻性临床试验，抗生素的最佳途径和持续时间仍未明确界定。奥他万星是一种长效、半合成糖肽类抗生素，对许多革兰氏阳性菌具有快速浓度依赖性杀菌活性。良好的药代动力学使奥他万星成为目前需要每日输注的抗生素的一种有吸引力的替代品，以降低与门诊抗菌治疗相关的血管通路并发症的风险。本研究的目的是报告 9 例慢性骨髓炎患者接受多剂量奥他万星治疗的结果。通过电子病历，在佐治亚州都柏林市 Meadows Regional Health System 旗下的一家医院所有的门诊伤口护理诊所和输液中心——都柏林市区伤口中心，确定了 2015 年 9 月至 2018 年 4 月期间，年龄≥18 岁的患者接受 i.v.奥他万星治疗的情况。在审查的 12 例病例中，9 例患者接受了至少 2 剂 i.v.奥他万星治疗慢性骨髓炎。在最后一剂奥他万星治疗后 6 个月的随访中，所有 9 例患者均达到临床治愈。当患者的复杂性或获得医疗服务的能力存在障碍限制了治疗选择时，多剂量奥他万星被发现是治疗慢性骨髓炎的一种安全有效的选择。
