Hatzenbuehler J, Pulling TJ, et al.
American family physician. Date of publication 2011 Nov 1;volume 84(9):1027-33.
1. Am Fam Physician. 2011 Nov 1;84(9):1027-33.
Diagnosis and management of osteomyelitis.
Hatzenbuehler J(1), Pulling TJ.
Author information:
(1)Maine Medical Center, Portland, USA. hatzej@mmc.org
Comment in
Am Fam Physician. 2012 Nov 15;86(10):888; author reply p. 888-9.
Summary for patients in
Am Fam Physician. 2011 Nov 1;84(9):1034.
The incidence of chronic osteomyelitis is increasing because of the prevalence of
predisposing conditions such as diabetes mellitus and peripheral vascular
disease. The increased availability of sensitive imaging tests, such as magnetic
resonance imaging and bone scintigraphy, has improved diagnostic accuracy and the
ability to characterize the infection. Plain radiography is a useful initial
investigation to identify alternative diagnoses and potential complications.
Direct sampling of the wound for culture and antimicrobial sensitivity is
essential to target treatment. The increased incidence of methicillin-resistant
Staphylococcus aureus osteomyelitis complicates antibiotic selection. Surgical
debridement is usually necessary in chronic cases. The recurrence rate remains
high despite surgical intervention and long-term antibiotic therapy. Acute
hematogenous osteomyelitis in children typically can be treated with a four-week
course of antibiotics. In adults, the duration of antibiotic treatment for
chronic osteomyelitis is typically several weeks longer. In both situations,
however, empiric antibiotic coverage for S. aureus is indicated.
PMID: 22046943 [Indexed for MEDLINE]
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