ANTIMICROBIAL TREATMENT OF OSTEOMYELITIS

Parenteral antibiotic therapy remains the mainstay of antimicrobial th erapy for osteomyelitis. In acute cases, empirical treatment may be us ed initially, but antibiotic selection should ideally be based on deep aspiration or bone cultures with corresponding in vitro sensitivity t esting. The drug exhibiting the highest bacteriocidal activity with th e least toxicity and lowest cost should be chosen. Antibiotic treatmen t will not substitute for surgical debridement of infected devitalized bone. The length of treatment with parenteral therapy remains controv ersial. The six-week benchmark, which was determined largely by experi ence with childhood hematogenous osteomyelitis, may not be applicable to contiguous focus osteomyelitis after trauma in adults. The goal of surgical treatment is to convert an infection with dead bone to a situ ation with well-vascularized tissues that are readily penetrated by bl ood-borne antibiotics, making prolonged drug treatment unnecessary.