Standard versus Specific Therapy for Chronic Osteomyelitis Treatment

Abstract

58 patients with chronic osteomyelitis were treated either with a standard therapy or with a specific targeted therapy based on the antibiogram assay. Standard therapy was performed by a 15-day course of a parenteral cephalosporin (usually ceftriaxone) in combination with an aminoglycoside (e.g. netilmicin), followed by oral therapy with a fluoroquinolone (generally ciprofloxacin) for 1 to 3 months; specific therapy largely varied depending on the antibiogram response. The results indicated that no significant differences were found between the patients who received standard therapy (95.5 % cured) and those who received a specific therapy (93.5 % cured), after a one year follow-up. It can be concluded that a short-term combined parenteral-oral standard therapy, indicated in all those cases where antibiotic therapy must be started before obtaining the laboratory response, or when a clear and definite identification of the microorganisms involved in the infection is not possible, can be as efficient as an antibiogram-guided therapy in the treatment of chronic osteomyelitis.

Ciprofloxacin monoolein water gels as implants for the treatment of chronic osteomyelitis: In vitro characterization

“…This drug is a fluoroquinolone and is widely used in the treatment of bacterial bone infection. [ 11 12 13 ] Indeed, it has an action over most of the germ spectrum encountered in chronic osteomyelitis including aminoglycoside-resistant germs, low toxicity and suitable bone diffusion. [ 1 14 15 ]…”