Long-term Intravenous Antibiotic Therapy in Chronic Osteomyelitis

Wagner, David K.; Collier, B D; Rytel, Michael W.

doi:10.1001/archinte.1985.00360060139022

Cited by 21 publications

(2 citation statements)

References 31 publications

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“…Cure was defined as clinical resolution of symptoms, radiologic evidence of healing (i.e., resolution of a radiologic diagnostic criterion of S/CO), or a Wintrobe erythrocyte sedimentation rate (ESR) that returned to normal (≤20 mm/hr). These criteria were modified from those used by Wagner et al 17 In 1999 and 2000 we attempted phone follow-up (at least 2 attempts) on all children diagnosed with S/CO to determine residual disability and long-term clinical course. Data frequency distributions were examined.…”

Section: Methodsmentioning

confidence: 99%

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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To identify factors associated with and to describe treatment outcomes of pediatric subacute or chronic osteomyelitis (S/CO), we retrospectively identified 52 patients with S/CO from January 1994 to November 1999 seen at a large pediatric hospital infectious disease clinic. S/CO was defined by the following: >10 days of clinical symptoms; radiographic, surgical, or pathologic changes consistent with S/CO; or relapse of prior osteomyelitis. Of these patients 63% were male, median age 9 years. Bones involved included vertebra (19% of subjects), femur (17%), finger (12%), humerus (10%), and tibia (8%). Sixty-five percent had at least 1 risk factor (most commonly hardware, neurologic disease or preceding trauma, sepsis, or surgery). Blood, bone, or wound aspirate cultures were positive in 67%, most commonly for Staphylococcus aureus. Erythrocyte sedimentation rate (ESR) was elevated in 88% of 41 patients at the time of diagnosis. Intravenous antibiotics were given for a median of 6 weeks and oral antibiotics for a median of 4.5 months. One child had a complication. In conclusion, consideration of S/CO should be high when predisposing factors are present. ESR may be useful for determining effectiveness and duration of therapy. With prolonged antibiotic therapy nearly all patients demonstrated resolution of disease.

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Section: Methodsmentioning

confidence: 99%

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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“…Treatment failures occurred in all clinical trials, regardless of the duration of antibiotic therapy, mostly due to the emergence of resistant strains or inadequate surgical debridement. Longer courses (6 months or more) of intravenous or oral antibiotics have been attempted by some authors, but the outcome of those trials does not suggest any improvement in comparison with the 6-week therapy course [29][30][31].…”

Section: Antibiotic Treatmentmentioning

confidence: 99%

Long bone osteomyelitis

Lazzarini¹,

Lalla²,

Mader

2002

Curr Infect Dis Rep

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Osteomyelitis is a complex disease that is often associated with high morbidity and considerable health care costs. Bacteremia, contiguous focuses of infection, penetrating trauma, or surgery are the major predisposing factors for this infection. Bone necrosis and bone destruction occur early in the course of osteomyelitis, leading to a chronic process and eliminating the host's ability to eradicate the pathogens. The presence of poorly vascularized tissues, the adherence to bone structures and implants, and a slow bacterial replication rate are recognized as important factors for the persistence of the infection. Treatment of osteomyelitis is particularly challenging and involves adequate antimicrobial therapy and surgical debridement of all necrotic bone and soft tissues. Antibiotic treatment is usually started on an empiric basis and then modified according to the results of cultures and sensitivity tests. Surgical treatment consists of debridement, obliteration of dead space, adequate soft tissue coverage, restoration of blood supply, and stabilization.

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imaging osteomyelitis

Aliabadi

Nikpoor

1994

Arthritis & Rheumatism

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Long-term Intravenous Antibiotic Therapy in Chronic Osteomyelitis

Cited by 21 publications

References 31 publications

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Long bone osteomyelitis

imaging osteomyelitis

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