Are Oral Antibiotics an Effective Alternative to Intravenous Antibiotics in Treatment of Osteomyelitis of the Jaw?

Lim, Rachel; Mills, Claire; Burke, Andrea B.; Dhanireddy, Shireesha; Beieler, Alison M; Dillon, Jasjit K.

doi:10.1016/j.joms.2021.04.020

Cited by 8 publications

(8 citation statements)

References 25 publications

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“…Oral antibiotics have been demonstrated to have comparable efficacy in treating osteomyelitis in different populations (diabetes, traumatic osteomyelitis, and osteomyelitis associated with hardware) and anatomic contexts [6,14,15,17]. The advantages of using oral over IV antibiotics include healthcare cost savings [10][11][12][13], shorter hospital stay [6,13], and the decreased incidence of catheter-related adverse events [12].…”

Section: Discussionmentioning

confidence: 99%

“…They defined "cure" by the absence of reactivation or persistence of infection at one year without any need for amputation [14]. For osteomyelitis of the jaw, Lim et al reported clinical resolution (defined by absence of clinical symptoms and radiographic improvement) in more than 80% of the patients two months after treatment completion when oral antibiotics were used with surgery without any preceding IV antibiotics [17]. Cordero-Ampuero et al followed 36 patients for a minimum of one year to assess if two-stage revision with interim oral antibiotics could eradicate hip arthroplasty infections [28].…”

Section: Efficacy Of Oral Antibiotics In Treatment Of Osteomyelitismentioning

confidence: 99%

“…Oral antibiotics for the treatment of osteomyelitis in specific bones have also been described, primarily through case studies and smaller series. For example, in jawbone and joint infections, common pathogens include viridans Streptococci, mixed anaerobic flora, coagulase-negative Staphylococcus, Actinomyces, Eikenella corrodens, Candida species, Neisseria species, Enterobacteriaceae, and Staphylococcus aureus [17]. The retrospective analysis of jaw osteomyelitis by Lim et al showed better outcomes at two months posttreatment in patients treated with oral antibiotics after surgery compared to those treated with IV antibiotics.…”

Section: Treatment Of Diabetic Osteomyelitismentioning

confidence: 99%

“…The retrospective analysis of jaw osteomyelitis by Lim et al showed better outcomes at two months posttreatment in patients treated with oral antibiotics after surgery compared to those treated with IV antibiotics. The oral antibiotics that have been successfully used for jaw osteomyelitis treatment include amoxicillin, amoxicillin/clavulanic acid, clindamycin, moxifloxacin, cotrimoxazole, and penicillin [17]. As for bone and joint infections in the hand, a retrospective study of 61 patients with acute inoculation osteomyelitis of the hand were treated with oral antibiotics for six months; this resulted in a 100% cure rate [11].…”

Section: Treatment Of Diabetic Osteomyelitismentioning

confidence: 99%

“…This variability complicates standardized recommendations for its management, particularly when it comes to the use of oral therapies. The antimicrobials used for bone and joint infections include cotrimoxazole [11,14,16,17], linezolid [16], rifampin [16], fluroquinolones [11,14,17], clindamycin [17], doxycycline [14], amoxicillin [17], amoxicillin/clavulanic acid [17], penicillin [17], and metronidazole [18,19]. The commonly recommended dosing regimens are listed in Table 1.…”

Section: Introductionmentioning

confidence: 99%

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A Review of the Clinical Utilization of Oral Antibacterial Therapy in the Treatment of Bone Infections in Adults

Haddad,

Ajaz,

Mansour

et al. 2023

Antibiotics

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Chronic osteomyelitis in adults is managed with prolonged courses of intravenous antibiotics in conjunction with surgical debridement of necrotic bone. Over the past 40 years, there has been no paradigm shift in this approach, as randomized controlled trials of this standard of care compared to alternatives such as prolonged oral antibiotics are scarce. However, there have been many small trials, case reports, and review papers evaluating the effectiveness of oral treatment for chronic osteomyelitis. The oral route for infections requiring prolonged treatment is intuitively and practically more favorable due to several advantages, the most important of which is the avoidance of long-term IV antimicrobial therapy with its complications, inconvenience, and cost. In this paper, we review the literature evaluating oral antibiotic therapy in the management of chronic bone infections since 1975. The majority of osteomyelitis infections are caused by Staphylococcus aureus, hence we focus on its treatment using oral antibiotics; however, we also emphasize subpopulations of patients with diabetes, implanted hardware, and with less common bacterial organisms. The primary objective of this review is to promulgate clinical recommendations on the use of oral antibiotics in bone infections in the context of initial therapy, transition from intravenous therapy, and the role of chronic suppression. The secondary objective is to summarize current knowledge of the specific oral antimicrobial agents that are commonly utilized, together with a synopsis of the available literature pertaining to their pharmacokinetic/pharmacodynamic properties and duration of therapy in bone infection.

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