COMBINED TREATMENT WITH ANTIBIOTIC, HEPARIN AND STREPTOKINASE - A NEWAPPROACH TO THE THERAPY OF BACTERIAL OSTEOMYELITIS

Combined treatment by continuous intravenous infusion of a selected an tibiotic and heparin and/or streptokinase was elaborated as a method o f causal, systemic treatment of bacterial osteomyelitis. The aim of th e combined treatment was to overcome infection and disturbances in the coagulation and fibrinolysis system which lead to impairment of the b one blood supply and its subsequent necrosis as the main factor in the aetiopathology of osteomyelitis. Between 1969 and 1991, combined trea tment was introduced in 63 patients with acute onset disease or with c hronic osteomyelitis. Osteomyelitis was located in the mandible in 38 patients and in the long bones in 14 patients. Prior to combined treat ment, moderate bone surgery was performed in 21 patients, while 31 pat ients were excluded from surgery. Combined treatment with an antibioti c and heparin (A + H) was performed in 43 patients, and the other 6 pa tients had infusion of an antibiotic, streptokinase and heparin (A + S + H). The authors' method of combined treatment offers a new approach and an alternative to routinely-ordered antibiotic therapy and radica l surgery, which allow frequent recurrences of the disease, a long-las ting course and severe complications.