USE OF THE SERUM BACTERICIDAL TITER TO ASSESS THE ADEQUACY OF ORAL ANTIBIOTIC-THERAPY IN THE TREATMENT OF ACUTE HEMATOGENOUS OSTEOMYELITIS

Serum bactericidal titers against Staphylococcus aureus were measured in 63 children who were receivingnafcillin or methicillin intravenously, or dicloxacillin, penicillin, or cephalexin orally. The SBTs obtained following unit doses of 25 mg/kg of dicloxacillin, 35 mg/kg of penicillin, or 25 mg/kg of cephalexin with probenecid were comparable to those seen following intravenous doses of 40 mg/kg nafcillin or methicillin. Twenty-two children with acute hematogenous osteomyelitis proven or presumed to be due to S. aureus were treated intravenously until point tenderness and fever had resolved, and then with oral therapy. The mean duration of intravenous therapy was 14 days. Oral doses were adjusted so that a peak SBT of ≥1:16 and a trough SBT of ≥1:2 were obtained in most children. No recurrences occurred. The SBT proved to be a practical means of assessing the adequacy of oral therapy in children with infections due to S. aureus. © 1979 The C. V. Mosby Company.