General and Local Antibiotic Treatment of Chronic Osteomyelitis

Abstract

A study of 36 chronic osteomyelitis patients is presented, with an account of, inter alia, symptoms, pathogenesis, bacteriology, serology, and other laboratory data. Almost throughout, the infective agent was Staphylococcus aureus and the treatment cloxacillin (0.5–1 g 5–6 times a day perorally). Antibiotics in dextran emulsion were injected into fistulas twice daily. Osteosynthesis material prolonged definitive healing. After antibiotic treatment for less than 6 months, the tendency to recurrence was considerably higher than after treatment for more than 6 months. Traumatic pathogenesis, ESR above 70 mm/1 h, and raised antistaphylolysin titre were prognostically unfavourable factors. The treatment resulted in healing in 90% of staphylococcal osteomyelitis cases. The observation period was 4–33 months after termination of treatment in 16 patients.