Oral Treatment Options for Chronic Osteomyelitis

Chronic infections of bone and joint usually occur in adults from trauma, contiguous soft-tissue infections, or orthopedic implants. In most cases Staphylococcus aureus is the pathogen, although other bacteria are also involved. Symptoms include pain, fever, wound drainage, and necrosis. Treatment options include surgical removal of dead tissues and orthopedic implants and prolonged (>= 6 wk) antibiotic therapy. Antibacterial therapy administered parenterally or orally has produced similar therapeutic benefits. Current literature supports oral therapy as a viable option for long-term treatment of chronic osteomyelitis; however, sufficient data from well-designed comparative studies are lacking. Upon completion of these studies, concerns regarding dosing, duration, and combination oral therapy may be resolved.