10.2 Chronic Osteomyelitis
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Acute on chronic (accompanied with fever) | Blood culture should be obtained before starting antimicrobial therapy. Empirical treatment should be started with narrow spectrum antibiotic. Definitive antibiotic therapy should be started as soon as culture results are available. Empirical therapy as per guidelines for acute osteomyelitis. | Same as in acute osteomyelitis | It is a continuous bacterial infection involving cortical bone. Surgical debridement of all diseased bone is often required as antibiotics penetrate poorly into infected fluid collections such as abscesses and injured or necrotic bone. Once susceptibility data becomes available, antibiotic therapy should be narrowed for targeted coverage of the susceptible organisms. |
For common etiological agents of Chronic Osteomyelitis, see Annexure B.10.2
Additional Information
- Supportive care should be continued and then narrow spectrum therapy must be initiated based on the results of investigations.
References
1. Ahmed Barakat, William HK. Schilling, Sunil Sharma, Enis Guryel, Richard Freeman. Chronic osteomyelitis: a review on current concepts and trends in treatment, Orthopaedics and Trauma, Volume 33, Issue 3,2019,Pages 181-187,ISSN 1877-1327. DOI: http://doi.org/10.1016/j.mporth.2019.03.005