P41 Use of delafloxacin in osteomyelitis: a case report

Abstract Background Data and experience with delafloxacin use in osteomyelitis (OM) other deep-seated infections are limited, yet the burden of OM on healthcare systems is significant. We hereby describe first case, to our knowledge, OM. Case description A 94-year-old male a history prostate cancer, hypertension heart failure was admitted hospital June 2022 grade 4 bilateral heel ulcers. Empirical IV co-amoxiclav started then escalated piperacillin/tazobactam. MRI scans confirmed diagnosis OM, tissue bone samples grew MDR Pseudomonas aeruginosa (piperacillin/tazobactam-resistant ciprofloxacin intermediate), an additional challenge. Due this result poor clinical response, meropenem prescribed. Off-label discussed within multidisciplinary team (MDT) switch oral administration, decrease length stay account for patient’s age co-morbidities. Minimum inhibitory concentration P. using EUCAST guidelines demonstrated susceptibility (0.125 mg/L). Delafloxacin also has good bioavailability does not require therapeutic drug monitoring. The patient 450 mg twice daily monitoring response. After 10 days initial in-hospital monitoring, discharged home complete 28 therapy. Follow-up imaging planned given his District nurses reported improvement On follow-up telephone consultation treating consultant November 2022, feeling well noted Readmission adverse events have been date ulcers continue improve. Conclusions This case presents successful osteomyelitis, tolerability response against aeruginosa. enabled be 3 weeks earlier than which would otherwise possible, improving quality life reducing risk hospital-acquired associated costs. enables early support antimicrobial stewardship agenda.