It can be difficult to completely eliminate osteomyelitis, which can become a chronic infection. Multiple surgeries may be needed to completely remove the damaged or dead bone.
An infection in your bone can impede blood circulation within the bone, leading to bone death. Areas where bone has died need to be surgically removed for antibiotics to be effective. Septic arthritis. Sometimes, infection within bones can spread into a nearby joint.
Because of the unique structure and nature of bone and its blood supply, infections can be very difficult to treat. If antibiotics are unable to eradicate the bone infection, surgery is sometimes required to remove the infection and any associated dead and infected bone.
With treatment, the outcome for acute osteomyelitis is often good. The outlook is worse for those with long-term (chronic) osteomyelitis. Symptoms may come and go for years, even with surgery. Amputation may be needed, especially in people with diabetes or poor blood circulation.
The infection spreads to the bone after several days or weeks. This type of spread is particularly likely to occur in older people. Such an infection may start in an area damaged by an injury or surgery, radiation therapy, or cancer or in a skin ulcer (particularly a foot ulcer) caused by poor circulation or diabetes.
Treatment for osteomyelitis
You'll usually take antibiotics for 4 to 6 weeks. If you have a severe infection, the course may last up to 12 weeks. It's important to finish a course of antibiotics even if you start to feel better.
The symptoms of osteomyelitis can depend on the location of the infection, its severity, and the person's age and general health. They commonly include: pain, which can be severe. swelling and tenderness in the affected area.
Antibiotics help bring the infection under control and often make it possible to avoid surgery. People with osteomyelitis usually get antibiotics for several weeks through an IV, and then switch to a pill. More serious or chronic osteomyelitis requires surgery to remove the infected tissue and bone.
Stage 4, or diffuse, osteomyelitis involves the entire thickness of the bone, with loss of stability, as in infected nonunion. The Cierny-Mader system adds a second dimension, characterizing the host as either A, B, or C. The A hosts are patients without systemic or local compromising factors.
Osteomyelitis affects about 2 to 5 out of every 10,000 people. It's one of the oldest diseases on record. Scientists have traced it back more than 250 million years.
Debridement for Infections
When infection occurs deep inside the body, the infection can become so involved in the soft-tissues that the only way to adequately remove the infection is to debride some of these tissues.
If inflammation resolves promptly, then proper bone healing may occur. However, if inflammation persists (which might occur in the presence of an infected implant or graft material), then the continued inflammatory response may result in suboptimal bone formation.
Is bone infection difficult to treat? Bone infection can be difficult to treat because bacteria are constantly changing to fight the new antibiotics that are used to kill them.
Non-Surgical Treatment for Osteomyelitis
Non-surgical treatment of osteomyelitis requires a multidisciplinary team approach including primary care, infectious disease specialist care, nutritionist care and wound care. These wounds will require antibiotic therapy for a duration of six to eight weeks.
They may cause acute sepsis with bone and joint destruction, chronic pain, discharging wounds and permanent disability. With expanding populations and increasing age, bone and joint infections, especially those involving devices, will have a growing impact on healthcare resources.
The crude mortality rate of osteomyelitis associated with diabetes increased with age (<55 years: 0.50, 95% CI: 0.48–0.52; 55 to 64 years: 5.49, 95% CI: 5.30–5.67; 65 to 74 years: 11.77, 95% CI: 11.44–12.10; 75 to 84 years: 21.82, 95% CI: 21.25–22.40; and 85+ years: 36.86, 95% CI: 35.67–38.05).
Treatment may include: Medications. Administration of intravenous (IV) antibiotics, which may require hospitalization or may be given on an outpatient schedule. Intravenous or oral antibiotic treatment for osteomyelitis may be very extensive, lasting for many weeks.
To diagnose a bone infection, doctors first perform a physical exam, looking for any open wounds or areas of tenderness, swelling, and redness. They may ask if you've had any recent infections, physical trauma, or surgery, or if you have experienced any pain or decreased range of motion in the affected limb.
Osteomyelitis may occur when an infection elsewhere in the body, such as a urinary tract infection or pneumonia, spreads through the blood to the bones. This type of bone infection is known as hematogenous osteomyelitis.
Primary treatment is a combination of penicillinase-resistant synthetic penicillin and a third-generation cephalosporin. Alternate therapy is vancomycin or clindamycin and a third-generation cephalosporin, particularly if methicillin-resistant S aureus (MRSA) is considered likely.
In adults, osteomyelitis most often affects the vertebrae of the spine and/or the hips. However, extremities are frequently involved due to skin wounds, trauma and surgeries.
Treatment of Bone and Joint Infections
Treatment usually begins by removing the source of the infection — typically through surgery — and antibiotics. Surgeons remove infected bone through a process called debridement. They clean out the infected bone and remove the source of the infection.