Osteomyelitis

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Treatments and drugs

By Mayo Clinic staff

The most common treatments for osteomyelitis are antibiotics and surgery to remove portions of bone that are infected or dead. Hospitalization is usually necessary.

Medications
A bone biopsy will reveal what type of germ is causing your infection, so your doctor can choose an antibiotic that works particularly well for that type of infection. The antibiotics are usually administered through a vein in your arm for at least four to six weeks. Side effects may include nausea, vomiting and diarrhea. An additional course of oral antibiotics may also be needed for more-serious infections.

Surgery
Depending on the severity of the infection, osteomyelitis surgery may include one or more of the following procedures:

  • Drain the infected area. Opening up the area around your infected bone allows your surgeon to drain any pus or fluid that has accumulated in response to the infection.
  • Remove diseased bone and tissue. In a procedure called debridement, the surgeon removes as much of the diseased bone as possible, taking a small margin of healthy bone to ensure that all the infected areas have been removed. Surrounding tissue that shows signs of infection also may be removed.
  • Restore blood flow to the bone. Your surgeon may fill any empty space left by the debridement procedure with a piece of bone or other tissue, such as skin or muscle, from another part of your body. Sometimes temporary fillers are placed in the pocket until you're healthy enough to undergo a bone graft or tissue graft. The graft helps your body repair damaged blood vessels and form new bone.
  • Remove any foreign objects. In some cases, foreign objects, such as surgical plates or screws placed during a previous surgery, may have to be removed.
  • Amputate the limb. As a last resort, surgeons may amputate the affected limb to stop the infection from spreading further.

Hyperbaric oxygen therapy
In people with very difficult-to-treat osteomyelitis, hyperbaric oxygen therapy may help get more oxygen to the bone and promote healing. Hyperbaric oxygen therapy is a means of delivering more oxygen than is normally available in the atmosphere. This is done using a pressure chamber that resembles a large, clear tube.

References
  1. Chihara S, et al. Osteomyelitis. Disease-a-Month. 2010;56:6.
  2. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Oct. 1, 2012.
  3. Humphries RL, et al. Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=55756409. Accessed Oct. 1, 2012.
  4. Lalani T. Overview of osteomyelitis in adults. http://www.uptodate.com/index. Accessed Sept. 21, 2012.
  5. Ray CG, et al. Sherris Medical Microbiology. 5th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aID=6950257. Accessed Oct. 1, 2012.
  6. Sia IG, et al. Osteomyelitis. Best Practice & Research Clinical Rheumatology. 2006; 20:1065.
  7. Infections. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00197. Accessed Oct. 5, 2012.
DS00759 Nov. 20, 2012

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