Treatment of osteomyelitis

The pathogenesis of osteomyelitis is a complex process involving interactions between a host and an infectious agent. The host’s inflammatory response to a pathogen can further the physical spread of disease by clearing space in bone. Predisposing genetic differences in immune function are increasingly seen as an aetiological factor in some cases of osteomyelitis. Acquired factors such as diseases causing immune or vascular compromise and implantation of foreign materials are frequently involved in the disease process as well. ...

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The progression of disease in localized osteomyelitis is characterized by a cycle of microbial invasion, vascular disruption, necrosis and sequestration. The host inflammatory response, discussed in detail below, results in obstruction of small vessels due to coagulopathy and oedema. As a result of this, cortical bone undergoes necrosis and is detached from surrounding live bone, creating an area known as a sequestrum. This provides a fertile environment for further bacterial invasion and progression continues.

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Contiguous-Focus Osteomyelitis Even when diagnosed early, contiguous-focus osteomyelitis usually requires surgery in addition to 4–6 weeks of appropriate antibiotic therapy because of underlying soft tissue infection or damage to bone from an injury or surgery. A 2-week course of antibiotics after thorough debridement and soft tissue coverage has yielded adequate results in the treatment of superficial osteomyelitis involving only the outer cortex of bone.

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful treatment of Mycobacterium ulcerans osteomyelitis with minor surgical debridement and prolonged rifampicin and ciprofloxacin therapy: a case report

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Table 120-2 Selection of Antibiotics for Treatment of Acute Osteomyelitis Suggested Regimena Organism Primary Alternativesb Staphylococcus aureus Penicillin- Nafcillin or oxacillin, 2 g Cefazolin, 1 g IV resistant, methicillin- IV q4h q8h; ceftriaxone, 1 g IV q24h; clindamycin, 900 mg IV q8hc sensitive (MSSA) Penicillinsensitive Penicillin, 3–4 million U IV q4h Cefazolin, ceftriaxone, clindamycin (as above) Methicillinresistant (MRSA) Vancomycin, 15 mg/kg Clindamycinc (as IV q12h; rifampin, 300 mg PO above); linezolid, 600 q12h (see text) mg IV or PO q12hd; daptomyci...

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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful treatment of perineal necrotising fasciitis and associated pubic bone osteomyelitis with the vacuum assisted closure system

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Harrison's Internal Medicine Chapter 120. Osteomyelitis Osteomyelitis: Introduction Osteomyelitis, an infection of bone, is caused most commonly by pyogenic bacteria and mycobacteria. As a useful framework for evaluating a patient and planning treatment, cases are classified on the basis of the causative agent; the route by which organisms gain access to bone; the duration of infection; the anatomic location of infection; and the local and systemic host factors that have a bearing on pathogenesis and outcome.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment...

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Osteomyelitis, an infection of bone, is caused most commonly by pyogenic bacteria and mycobacteria. As a useful framework for evaluating a patient and planning treatment, cases are classified on the basis of the causative agent; the route by which organisms gain access to bone; the duration of infection; the anatomic location of infection; and the local and systemic host factors that have a bearing on pathogenesis and outcome. Pathogenesis and Pathology Microorganisms enter bone by hematogenous dissemination, by spread from a contiguous focus of infection, or by a penetrating wound.

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