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Table 2 Individual Demographics, Diagnosis, Treatment, and Outcomes of Osteomyelitis Patients Treated with Ertapenem

From: Ertapenem for treatment of osteomyelitis: a case series

Patient

Age (yrs)

Race

Gender

Comorbidities

Diagnosis¥

Trauma-related

DiagnosticMethod

Surgical Intervention

No. Days on Erta

Other Antibiotic

Outcome at One Year£

1

47

White

Male

None

Recurrent chronic contiguous tibial osteomyelitis

Yes

Bone culture

Soft tissue debridement

39

None

F-Infection cleared at end of therapy, but recurred by one year

2

56

White

Female

COPD, DM, Pancreatic cancer

Initial chronic hematogenous vertebral osteomyelitis

Yes

Deep tissue culture

None

39

Suppressive moxifloxacin following ertapenem

F-Did not clear infection at end of therapy, but cleared by one year

3

70

White

Male

CAD, PVD

Initial chronic contiguous tibial osteomyelitis

Yes

Bone culture

Bone debridement

33

None

S-Infection cleared at end of therapy without recurrence at one year

4

41

White

Female

None

Initial acute contiguous toe osteomyelitis

Yes

MRI

None

43

Amoxicillin/clavulanate for 20 days preceding ertapenem

S-Infection cleared at end of therapy without recurrence at one year

5

72

White

Female

PVD, DM, CKD

Initial chronic contiguous toe osteomyelitis

Not

known

MRI

None

41

See footnote1

Suppressive cephalexin following ertapenem

F- Did not clear infection at end of therapy, but cleared by one year

6

64

Black

Female

PVD, DM

Recurrent chronic contiguous malleolar osteomyelitis

Not

known

MRI

None

35

Vancomycin and ampicillin/sulbactam for 6 days preceding ertapenem; suppressive ciprofloxacinclindamycin following ertapenem

F- Did not clear infection at end of therapy, but cleared by one year

7

79

White

Female

None

Initial chronic contiguous calcaneal ostemyelitis

No

Bone scan

None

24

None

S-Infection cleared at end of therapy without recurrence at one year

8

76

White

Female

Neurologic disease

Initial acute contiguous calcaneal osteomyelitis

No

MRI

Amputation

26

Imipenem for 14 days following therapy

S-Infection cleared at end of therapy without recurrence at one year

9

47

White

Female

DM

Initial chronic contiguous toe osteomyelitis

Not

known

MRI

None

42

Piperacillin/tazobactam for 9 days prior to ertapenem

S-Infection cleared at end of therapy without recurrence at one year

10

37

White

Male

DM

Initial chronic contiguous toe osteomyelitis

No

MRI

None

31

Ampicillin/sulbactam for 3 days prior to ertapenem

S-Infection cleared at end of therapy without recurrence at one year

11

48

Black

Female

PVD, DM

Initial acute contiguous toe osteomyelitis

No

Plain film

None

20

Vancomycin for 4 days, piperacillin/tazobactam, 3 days, ceftriaxone for 2 days, all prior to ertapenem

F-Did not clear infection at end of therapy, nor by one year

12

86

Black

Male

CAD, PVD, DM

Initial chronic contiguous toe osteomyelitis

No

MRI

None

42

Piperacillin/tazobactam for 5 days prior to ertapenem

F- Did not clear infection at end of therapy, but cleared by one year

  1. Comorbidities include chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), peripheral vascular disease (PVD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD), liver disease, connective tissue disorder, neurologic disease, human immunodeficiency virus (HIV), and hepatitis C virus (HCV).
  2. ¥Classification of osteomyelitis included the following definitions: Acute = less than four weeks of symptoms (bone pain, erythema, tenderness, or exposure through open wound) prior to presentation to a medical provider; chronic = greater than or equal to four weeks of symptoms prior to presentation; initial = first episode of osteomyelitis at current site; recurrent = repeat episode of osteomyelitis at current site; contiguous = any associated wound infection following surgery or trauma or cellulitis at the site of osteomyelitis occurring within two weeks prior to diagnosis; hematogenous = any osteomyelitis without a contiguous focus of infection associated with the osteomyelitis site.
  3. £S = success, defined as resolution of clinical signs and symptoms of infection such that discontinuation of antibiotics was deemed appropriate at end of ertapenem therapy, and no recurrence at one year; F = failure, any case not meeting criteria for success.
  4. 1Vancomycin for five days, ciprofloxacin for one day, metronidazole for two days, ceftazadime for four days, and imipenem for two days, all preceding ertapenem, and six days of clindamycin concurrently with ertapenem.