AAC Accepts, published online ahead of print on 19 October 2009

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Antimicrob. Agents Chemother. doi:10.1128/AAC.01081-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Continuous Clindamycin Infusion: an Innovative Approach to Treating Bone and Joint Infection

Valérie Zeller^*, Arnaud Dzeing-Ella, Marie-Dominique Kitzis, Jean-Marc Ziza, Patrick Mamoudy, and Nicole Desplaces

Service de Chirurgie Osseuse et Traumatologique, Service de Médecine Interne et Rhumatologie, Centre de Référence des Infections Ostéo-Articulaires, Laboratoire de Biologie Médicale, Groupe Hospitalier Diaconesses–Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France; Laboratoire de Microbiologie, Groupe Hospitalier Paris Saint-Joseph, 68, rue des Plantes, 75014 Paris, France

^* To whom correspondence should be addressed. Email: vzeller{at}hopital-dcss.org.

Feasibility, safety and efficacy of prolonged, continuous, intravenous clindamycin therapy were retrospectively evaluated for 70 patients treated for bone and joint infections, 40% as outpatients. Median treatment duration was 40 days, median daily clindamycin dose was 2400 mg and 3 moderate-grade adverse events occurred. Median serum clindamycin concentrations on days 3-14 and 8-28 were 5 and 6.2 mg/liter, respectively; the median concentration was significantly lower (P<0.02) in patients treated with rifampin (5.3 mg/liter) versus without rifampin (8.9 mg/liter). Among 53 patients with a median [range] follow-up of 30 [24–53] months, 49 (92%) were considered cured (1 relapse, 3 reinfections).