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 (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 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 (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 10⁹/L to 239 × 10⁹/L, p = 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 (n = 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.

中文翻译：

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长期使用替地唑烷治疗骨关节炎：恶唑烷酮类药物的益处

背景：评价长期使用替硝唑治疗骨关节感染的疗效和安全性。方法：多中心回顾性研究（2017年1月至2019年3月）对泰替唑酯治疗的骨关节感染病例进行研究。失败：尽管进行了抗生素治疗或需要抑制治疗，但临床恶化。结果：病例（n = 51； 59％的女性，平均年龄为65岁）包括骨关节炎（n = 27，53％），人工关节感染（n = 17、33.3％）和糖尿病足感染（n = 9）。 18％）；其中59％与整形外科设备有关。最常见的分离株是葡萄球菌。（65％，n= 47; 金黄色葡萄球菌，48％）。选择泰地唑的原因是潜在的药物相互作用（63％）和血细胞减少（55％）；中位治疗时间为29天（四分位间距-IQR-15-44），同时有24％的患者接受利福平（每天600 mg，一次），不良事件少（n = 3）。在整个治疗期间，血红蛋白和血小板计数保持稳定（分别从108.6 g / L到116.3 g / L，p = 0.079；从240×10 ⁹ / L到239×10 ⁹ / L，p = 0.942）。血细胞减少症的情况。在与器械相关的感染中，有33％的患者保留了植入物。中位随访时间为630天，总治愈率为83％；失败中（ñ= 8），其中63％是与设备相关的感染。结论：长期使用替硝唑是有效的，与利奈唑胺相比，显示出更好的安全性，较低的骨髓毒性和较低的药物相互作用。这些优势的证实可能会使替佐利特成为大多数骨关节感染的首选恶唑烷酮。