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Outpatient Antibiotic Therapy for Osteomyelitis-Reply

John M. Eisenberg, MD; Deborah S. Kitz, PhD
JAMA. 1987;258(3):322. doi:10.1001/jama.1987.03400030038013.
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In Reply.—  We sympathize with Drs Cohen and Weber's concern that physicians may rely inappropriately on a single scientific report in changing their practices. However, they may have misinterpreted the message of our report on potential savings from outpatient treatment of osteomyelitis. We presented the use of cefonicid as an example of a drug with which "earlydischarge therapy... may be enhanced." Based on the report by Kunkel and Iannini,1 as well as the submission of data for the drug's approval, we came to the same conclusion as the Food and Drug Administration—that cefonicid is an appropriate drug for treatment of many cases of osteomyelitis. Our economic analysis assumed that drug therapy would be started in the hospital and clinical response demonstrated before discharge for outpatient antibiotic therapy. Others have reached similar conclusions, including the authors of a comprehensive review of cefonicid,2 who wrote that "patients who require prolonged


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