TMP-SMX Is Another Option for Treatment of Acute Osteomyelitis

Transitioning from intravenous (IV) to oral antibiotic therapy for acute hematogenous osteomyelitis hastens the return to normal activities in children. However, emergence of methicillin-resistant Staphylococcus aureus (MRSA) limits the choice of an oral agent. Clindamycin has a good track record for treatment of MRSA osteomyelitis, but its use is limited by its unpalatable taste and increasing S. aureus resistance. MRSA resistance to trimethoprim-sulfamethoxazole (TMP-SMX) is rare. These investigators report their experience using TMP-SMX for treatment of 20 patients (age, ≤18 years) with proven or presumed osteomyelitis caused by S. aureus.

In most cases, patients did not receive TMP-SMX as initial IV therapy but rather as the oral transit…