Oral Quinolone Treatment for Osteomyelitis

Excerpt

To the Editors: In his editorial (1), Dr. Gentry asserts that oral antibiotic therapy with ciprofloxacin and other fluoroquinolones is as effective as parenteral therapy. Gentry did not, however, differentiate between the treatment of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) infections. Treatment of MRSA-related osteomyelitis using ciprofloxacin has yielded disappointing results (2). In fact, patients with MRSA-related osteomyelitis were excluded from a study comparing oral ciprofloxacin with parenteral therapy (3). Some patients receiving ciprofloxacin for staphylococcal (MRSA and MSSA) osteomyelitis as well as for skin and soft tissue infections, endocarditis, and eradication of colonization have developed ciprofloxacin-resistant