Antibiotic therapy for osteomyelitis

Antibiotic therapy for osteomyelitis has dramatically changed within the past twenty years. The diagnostic criteria for osteomyelitis remain confusing to practicing physicians. Bone biopsy culture is now the standard for determining specific antimicrobial therapy. Many of the newest and most potent antimicrobials are now used to treat the increasingly broad bacterial spectrum of etiologies of osteomyelitis. There are tremendous economic incentives for outpatient and/or oral therapy. The third-generation cephalosporins and the new fluoroquinolones have replaced older, more toxic regimens, especially those containing aminoglycoside used to treat gram-negative osteomyelitis due to susceptible organisms.