Courjon J, et al. - A monocentric cohort study was performed to assess the efficacy and safety of clindamycin-based treatment for bone and joint infections. Among the assessable patients, the therapy proved efficient in 111/133 cases (83%) and thus seemed a reliable and safe alternative treatment option.

Methods

• Authors' medical dashboard that prospectively recorded 28 characteristics for all hospitalized patients since July 2005, was studied.
• They selected bone and joint infections (BJIs), and then, included all mono-microbial BJI managed with clindamycin-based therapy.
• For this study, remission was defined as the absence of clinical and/or microbiological relapse after treatment.  
• They retrospectively determined the duration of follow-up without relapse using computerized medical records.

Results

• 196 BJIs were identified for 10 years, 80/196 (41%) were device-associated infections; these were treated with clindamycin-based therapy.
• The bacterial causative agent in 130 cases (66%) was Staphylococcus aureus , in 29 cases (15%) was coagulase-negative staphylococci, in 31 cases (16%) was streptococci and in 6 cases (3%) other bacteria were observed .
• Clindamycin, in combination therapy, was mainly paired with fluoroquinolones (31%) or rifampin (27%).
• The clindamycin treatment was provided for a mean duration of 7.4 ± 3.2 weeks (range, 1–24).
• For 9 (4.5%) patients an AE was recorded.
• Remission was observed in 111 (57%) patients, with a mean duration of clinical follow-up of 28 ± 24 months.
• Treatment failure encountered in 22 (11%) patients, 50 patients (25%) were lost to follow-up, and 8 (4%) required long-term suppressive therapy.