Osteomyelitis: Etiology, Diagnosis, Treatment and Outcome in a Public versus a Private Institution

Lobati, F; Herndon, Blair H.; Bamberger, David M.

doi:10.1007/s15010-001-1134-6

Cited by 24 publications

(12 citation statements)

References 6 publications

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“…Protocols would need to define the dosage, route of administration, and duration of antibiotic therapy. There are few data available on which to base these decisions, but in an era of highly bioavailable oral agents, there is little to support the recommendation to use intravenous drugs to initiate treatment [24,58]. Most agree that if surgery is withheld, antibiotics should be continued for 4-6 weeks or more [11,24].…”

Section: Studies To Determine the Relative Roles Of Medical And Surgimentioning

confidence: 99%

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Jeffcoate

Lipsky

2004

Clinical Infectious Diseases

214

145

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The optimal approach to diagnosing and managing osteomyelitis of the foot in diabetes is unclear. Diagnosis is based on clinical signs, supplemented by a variety of imaging tests. Bone biopsy is the accepted criterion standard for diagnosis but is not used by many. Management traditionally involves surgical removal of infected bone, combined with antibiotic therapy. However, recent studies have shown that antibiotics alone may apparently eliminate bone infection in many cases. There is also evidence that early amputation of infected digits is frequently noncurative. Agreement on criteria for diagnosing osteomyelitis is required, and randomized trials are urgently needed, to determine the relative benefits of various surgical interventions and the optimal deployment of antibiotics. We review the microbiology of osteomyelitis of the foot in diabetes, the benefits and limitations of various diagnostic procedures, and the evidence for the effectiveness of both surgical and nonsurgical approaches to management.

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Section: Studies To Determine the Relative Roles Of Medical And Surgimentioning

confidence: 99%

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Jeffcoate

Lipsky

2004

Clinical Infectious Diseases

214

145

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“…Although cryptic infection itself may not cause any clinical problems, whenever the host defense mechanisms are suppressed (i.e. systemic diseases, hypersensitivity to metallic implants), the bacteria may be recalcitrant and cause the infection leading to implant failure (Lobati et al 2001). In our study, we found that the patients with internal fixations with plates and screws were at a higher risk of infection.…”

Section: Discussionmentioning

confidence: 55%

“…Since P. aeruginosa was frequently found in our study, we assumed that it was the main nosocomial pathogen in our operating theatre. Furthermore, this species was also classified as the main nosocomial pathogen in humans (S tein et al 1998;Lobati et al 2001;V alenziano et al 2002). The mixed bacteria identified from the samples before and after implantation were in the same incidence.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Bacterial Infections in Extremities before and after Osteosynthesis in Small Animals

Soontornvipart¹,

Nečas²,

Dvořák³

et al. 2003

Acta Vet. Brno

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Posttraumatic osteomyelitis is one of the most serious complications after fracture treatment. Even though first-generation cephalosporins are always recommended as the first choice of antibiotic prophylaxis in orthopaedic surgery, they cannot eradicate all bacteria, which can enter into the fractured bone during orthopaedic procedures.The purpose of this study was to identify bacteria cultured from surgical wounds during osteosynthesis in order to select properly suitable antibiotic prophylaxis in our clinical practice. Our study was performed on 60 patients with long bone fractures operated at the Department of Surgery and Orthopaedics, Small Animal Clinic, University of Veterinary and Pharmaceutical Sciences, Brno. The patients without an antibiotic treatment 24 hours prior to surgery were included in the study. Samples for bacterial culture were collected before and after internal fixation of the fracture. Several factors possibly influencing the risk of infection were evaluated. Patients with severe degree of soft tissue damage and with open fractures were at higher risk of infection before osteosynthesis, whereas the patients younger than one year, with positive cultures before surgery, with plate and screw fixations, with primary bone healing, with abnormal radiographic findings and intramuscularly anesthetized patients were at a significantly higher risk of bacterial infection after the fracture fixation. A high percentage of the bacterial isolates was Pseudomonas aeruginosa resistent to cephalosporins. Although we use cephalosporins prophylactically in all patients undergoing orthopaedic surgery in our clinic, the incidence of postoperative infections was very low. Therefore, it is obvious that the use of cephalosporins as preoperative prophylaxis is sufficient in most cases. In the patients at high risk of osteomyelitis development (polytraumatized or immunosuppressed patients, patients receiving prosthetic joint or large metallic implants), or in the patients where the infection is already present, it is important to know hospital-specific pathogens to select adequate complementary antibiotics (in our case we use cephalosporines together with quinolones such as enrofloxain). This emphasizes the need of epidemiologic studies, specific for each clinic.

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“…Osteomyelitis is an inflammatory and infectious condition where Staphylococcus aureus is the most common infectious agent (Chihara and Segreti, 2010;Lew and Waldvogel, 2004;Lobati et al, 2001;O'May et al, 2011). Nowadays this disease is a public health problem with a significant morbidity and mortality (Lew and Waldvogel, 2004).…”

Section: Introductionmentioning

confidence: 99%

A new look at osteomyelitis development – Focus on CCR5delta32. Study in patients from Northeast Brazil

Souza

Souza²,

Cunha

et al. 2015

Infection, Genetics and Evolution

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Osteomyelitis: Etiology, Diagnosis, Treatment and Outcome in a Public versus a Private Institution

Abstract: Osteomyelitis patient outcome varies less by hospital setting than by case management.

Cited by 24 publications

References 6 publications

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Posttraumatic Bacterial Infections in Extremities before and after Osteosynthesis in Small Animals

A new look at osteomyelitis development – Focus on CCR5delta32. Study in patients from Northeast Brazil

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