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Treatments and drugs
By Mayo Clinic staffThe most common treatments for osteomyelitis are antibiotics and surgery to remove portions of bone that are infected or dead.
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 six weeks. Side effects may include nausea, vomiting and diarrhea.
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.
- Fort GG, et al. Osteomyelitis. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/191358793-4/974051922/2088/463.html#4-u1.0-B978-0-323-05609-0..00024-1--sc0070_9510. Accessed March 26, 2010.
- Chihara S, et al. Osteomyelitis. Disease-a-Month. 2010;56:6.
- Lalani T. Overview of osteomyelitis in adults. http://www.uptodate.com/home/index.html. Accessed March 26, 2010.
- Infections. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00197. Accessed March 26, 2010.
- Berbari EF, et al. Osteomyelitis. In: Mandell GL, et al. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-443-06839-3..00103-X&uniq=191840490&isbn=978-0-443-06839-3#lpState=opened&lpTab=contentsTab&content=4-u1.0-B978-0-443-06839-3..00103-X%3Btype%3DbookPage%3Bisbn%3D978-0-443-06839-3. Accessed March 29, 2010.
- Dabov DB. Amputation for osteomyelitis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/191847540-7/0/1584/111.html?tocnode=55686605&fromURL=111.html. Accessed March 29, 2010.
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