Is Ceftriaxone Effective for Staphylococcal Osteomyelitis?
Intravenous agents commonly used in the treatment of staphylococcal osteomyelitis include nafcillin, vancomycin and cefazolin. Although effective, they must be given in multiple doses, which may make ambulatory care problematic. While the third-generation cephalosporin ceftriaxone may not be as effective against Staphylococcus aureus as other agents, its long half-life allows for once-daily administration, which would be advantageous in at-home therapy. Guglielmo and colleagues evaluated the use of ceftriaxone for home therapy in adults with S. aureus osteomyelitis. The study included 31 patients who ranged in age from 27 to 75 years; for at-home therapy, 22 received ceftriaxone, in a dosage of 2 g daily, and nine received cefazolin or vancomycin. All of the patients were initially treated with one to two weeks of intravenous nafcillin, vancomycin or cefazolin before discharge from the hospital. Antimicrobial therapy was given for a mean duration of 49 ± 7 days. Follow-up was continued
