The aim of this study was to demonstrate that short course antibiotic therapy combined with surgical drainage and followed by oral antibiotic therapy is quite adequate and suggested a scoring system as a comfortable and reliable tool to adjust the route of drug administration.
Criteria for discontinuation of parenteral antibiotic Scoring criteriapoints Clinical evaluation A: improved active motion of the joint: l B: Painless active motion of the joint: 2 C: improvement in A &
B:3 Radiological findings A: progressive osteolysis ormultifocal involvement: 0 B: absence of the above findings*: 1 Laboratory evaluation A: drop of 50.00/mm3 in WBC count or return to normal range (5.000–10.000 /mni3): 0.5 B: drop in ESR of 30 mm/hr or return to level of 30 mm/hr or less: 0.5 Total score: 5 *Pure periosteal elevation received a score of 1. Patients with a score >
or equal to 4 would be switched to oral antibiotic.
The mean functional scoring between the short-term group and long-term group were similar P>
0.05. Overall, excellent or good results were achieved in both groups. No fair or poor results were observed. The average hospital cost for a patient in long-term group was twice that of a patient in short-term group.
A decision on prolonging the duration of parenteral antibiotics should be based on a combination of clear clinical, laboratory, and radiographic criteria, such us the scoring system presented in this article.