PURPOSE: The optimal duration of concomitant antibiotic therapy after surgical intervention for implant-free chronic osteomyelitis is unknown. No randomized data exist. Available recommendations are based on expert's opinion. We evaluated the duration of post-surgical antibiotic treatment related to remission of chronic osteomyelitis. METHODS: This was a retrospective single-centre study at Geneva University Hospitals with a minimal follow-up of two years after treatment. We used multivariate logistic regression analysis with exclusion of pediatric cases and of implant-related chronic osteomyelitis. RESULTS: A total of 49 episodes of implant-free chronic osteomyelitis in 49 adult patients were studied. The median number of surgical interventions was two (range, 1-10). The median duration of post-debridement antibiotic treatment was eight weeks (range, 4-14 weeks). Thirty-nine patients (80%) were in remission after a minimal follow-up of two years. In multivariate logistic regression analysis, one week of intravenous therapy had the same remission as two to three weeks (0.2, 0.1-1.9) or ≥ 3 weeks (0.3, 0.1-2.4). More than six weeks of total antibiotic treatment equalled ≤ six weeks (0.8, 0.1-5.2). CONCLUSIONS: In chronic osteomyelitis in adults, a post-debridement antibiotic therapy beyond six weeks, or an IV treatment longer than one week, did not show enhanced remission incidences. Prospective randomized trials are required to confirm this observation.
PURPOSE: The optimal duration of concomitant antibiotic therapy after surgical intervention for implant-free chronic osteomyelitis is unknown. No randomized data exist. Available recommendations are based on expert's opinion. We evaluated the duration of post-surgical antibiotic treatment related to remission of chronic osteomyelitis. METHODS: This was a retrospective single-centre study at Geneva University Hospitals with a minimal follow-up of two years after treatment. We used multivariate logistic regression analysis with exclusion of pediatric cases and of implant-related chronic osteomyelitis. RESULTS: A total of 49 episodes of implant-free chronic osteomyelitis in 49 adult patients were studied. The median number of surgical interventions was two (range, 1-10). The median duration of post-debridement antibiotic treatment was eight weeks (range, 4-14 weeks). Thirty-nine patients (80%) were in remission after a minimal follow-up of two years. In multivariate logistic regression analysis, one week of intravenous therapy had the same remission as two to three weeks (0.2, 0.1-1.9) or ≥ 3 weeks (0.3, 0.1-2.4). More than six weeks of total antibiotic treatment equalled ≤ six weeks (0.8, 0.1-5.2). CONCLUSIONS: In chronic osteomyelitis in adults, a post-debridement antibiotic therapy beyond six weeks, or an IV treatment longer than one week, did not show enhanced remission incidences. Prospective randomized trials are required to confirm this observation.
Authors: Ilker Uçkay; Mathieu Assal; Laurence Legout; Peter Rohner; Richard Stern; Daniel Lew; Pierre Hoffmeyer; Louis Bernard Journal: J Clin Microbiol Date: 2006-03 Impact factor: 5.948
Authors: Philippa C Matthews; Christopher P Conlon; Anthony R Berendt; Jill Kayley; Lorrayne Jefferies; Bridget L Atkins; Ivor Byren Journal: J Antimicrob Chemother Date: 2007-06-11 Impact factor: 5.790
Authors: Mohamed Al-Mayahi; Michael Betz; Daniel A Müller; Richard Stern; Phedon Tahintzi; Louis Bernard; Pierre Hoffmeyer; Domizio Suvà; Ilker Uçkay Journal: Int Orthop Date: 2013-09-20 Impact factor: 3.075
Authors: Christian Fölsch; Maike Federmann; Klaus D Kuehn; Clemens Kittinger; Stefan Kogler; Gernot Zarfel; Martina Kerwat; Steve Braun; Susanne Fuchs-Winkelmann; Jürgen R J Paletta; Philip P Roessler Journal: Int Orthop Date: 2014-11-08 Impact factor: 3.075