Early switching from intravenous to oral antibiotic therapy in bone and joint infections associated with methicillin-susceptible Staphylococcus aureus bacteremia

Abstract

Objectives: We aimed to evaluate the clinical outcomes of patients with bone and joint infection (BJI) associated with methicillin-susceptible Staphylococcus aureus bacteremia (MSSAB) treated with early oral switch to oral antibiotics (before day 14) versus later or no switch.

Patients and methods: We included all cases reported between January 2016 and December 2021 in the University Hospital of Reims.

Results: Among 79 patients with BJI associated with MSSAB, 50.6% had an early switch to oral antibiotics, with median duration of intravenous antibiotics of 9 (IQR 6-11) days. The overall cure rate was 81% with follow-up of 6 months, and was 85.7% after excluding the 9 patients whose death was not related to BJI infection. Failure to control BJI did not differ between the two groups.

Conclusion: An early (before day 14) switch to oral antibiotics may be a safe therapeutic option in BJI associated with MSSAB.

Keywords: Bone and joint infections; Oral antibiotics; Staphylococcus aureus bacteremia.