Treatment of bone and joint infections caused by Enterobacter cloacae with a fluoroquinolone-cotrimoxazole combination

Int J Antimicrob Agents. 2019 Aug;54(2):245-248. doi: 10.1016/j.ijantimicag.2019.05.010. Epub 2019 May 13.

Abstract

Although the frequency of bone and joint infections caused by Enterobacter spp. is increasing, studies regarding the optimal antibiotic therapy are scarce. The objective of this retrospective study was to assess the clinical outcomes and safety of a fluoroquinolone-cotrimoxazole combination for the treatment of bone and joint infections caused by Enterobacter cloacae. Between 2010 and 2017, 30 patients with bone and joint infections caused by E. cloacae were treated with a fluoroquinolone-cotrimoxazole combination for 8-12 weeks. There were 26 cases (87%) of infection of an internal fixation device, two cases (6.6%) of pseudarthrosis with chronic osteomyelitis, and two cases (6.6%) of infection of knee and ankle prosthetic devices. The cure rate of the fluoroquinolone-cotrimoxazole combination was 80% by intention-to-treat analysis, with a mean follow-up of 29.3 ± 19.1 months. The fluoroquinolone-cotrimoxazole combination for 8-12 weeks is effective for the treatment of bone and joint infections caused by E. cloacae.

Keywords: Bone infection; Cotrimoxazole; Enterobacter cloacae; Enterobacter spp.; Fluoroquinolone; Fluoroquinolone–cotrimoxazole combination.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Arthritis / drug therapy*
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Enterobacter cloacae / drug effects*
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / microbiology
  • Female
  • Fluoroquinolones / administration & dosage*
  • Fluoroquinolones / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / drug therapy*
  • Prosthesis-Related Infections / drug therapy
  • Retrospective Studies
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage*
  • Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Trimethoprim, Sulfamethoxazole Drug Combination