Long-Term Use of Tedizolid in Osteoarticular Infections: Benefits among Oxazolidinone Drugs.

BACKGROUND

To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections.

METHODS

Multicentric retrospective study (January 2017-March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment.

RESULTS

Cases ( = 51; 59% women, mean age of 65 years) included osteoarthritis ( = 27, 53%), prosthetic joint infection ( = 17, 33.3%), and diabetic foot infections ( = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15-44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce ( = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, = 0.079; and 240 × 10/L to 239 × 10/L, = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures ( = 8), 63% were device-related infections.

CONCLUSIONS

Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.