Related Experiment Video
Updated: May 8, 2026
06:18
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Antibiotics for treating chronic osteomyelitis in adults
Lucieni O Conterno1, Marilia D Turchi
1Department of General Internal Medicine and Clinical Epidemiology Unit, Marilia Medical School, Avenida Monte Carmelo 800, Fragata, Marilia, São Paulo, Brazil, 17519-030.
The Cochrane Database of Systematic Reviews
|September 10, 2013
Summary
Systemic antibiotic treatment for chronic osteomyelitis shows no significant difference between oral and parenteral routes for disease remission. Further research is needed to confirm findings and address antibiotic resistance challenges.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Pharmacology
Background:
- Chronic osteomyelitis presents a persistent therapeutic challenge with a 20% recurrence rate despite current antibiotic and surgical interventions.
- This review is an update of previous Cochrane reviews on chronic osteomyelitis treatment, first published in 2009.
Purpose of the Study:
- To evaluate the efficacy of various systemic antibiotic regimens for treating chronic osteomyelitis in adult patients.
- To compare oral versus parenteral antibiotic administration routes in chronic osteomyelitis management.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, and LILACS up to October 2012.
- Data extraction and risk of bias assessment were performed independently by two reviewers.
Main Results:
- Eight small trials with 282 participants were included; data from 248 were available.
- No statistically significant difference in remission rates was found between oral and parenteral antibiotic administration (RR 1.04, 95% CI 0.92 to 1.18).
- Adverse events and superinfection rates were similar between oral and parenteral groups; study quality was generally low with moderate to high risk of bias.
Conclusions:
- Limited evidence suggests the route of antibiotic administration does not impact remission rates for susceptible bacteria.
- Further high-quality trials are necessary to confirm these findings and evaluate other aspects of antibiotic therapy.
- Increasing antibiotic resistance poses a significant challenge for future chronic osteomyelitis treatment strategies.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
01:28Inhibitors of Bacterial DNA Synthesis
Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
01:25Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...