Treatment-osteomyelitis
- Antibiotics: based on cx data.
- If clinically stable, consider holding antibiotics until bone bx obtained.
- Duration depends on Rx strategy/goals of Rx management (eg, 6 wks for vertebral osteo; Lancet 2015;385:875).
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After ≥7 days from either start of IV abx or surgery, if doing well consider (in consultation with ID!) ∆’ing IV to PO (if good bioavailability and bone penetration) (NEJM 2019;380:425).
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Surgery should be considered for any of the following: acute osteo that fails to respond to medical Rx, chronic osteo, complications of pyogenic vertebral osteo (eg, neurologic compromise, spinal instability, epidural abscess) or infected prosthesis
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- Treatment for osteomyelitis typically involves antibiotics, which are chosen based on culture data.
- If the patient is clinically stable, antibiotics may be withheld until a bone biopsy can be obtained.
- The duration of treatment depends on the chosen strategy and goals of treatment management. For example, treatment for vertebral osteomyelitis may last for six weeks.
- After seven days from either the start of intravenous antibiotics or surgery, if the patient is doing well, they may be switched to oral antibiotics (if there is good bioavailability and bone penetration).
- Surgery should be considered for any of the following: acute osteomyelitis that fails to respond to medical treatment, chronic osteomyelitis, complications of pyogenic vertebral osteomyelitis (e.g. neurologic compromise, spinal instability, epidural abscess), or infected prosthesis.
窩的英文不太好
- 骨髓炎的治療通常涉及根據培養數據選擇的抗生素。 -如果患者臨床穩定，可以暫停使用抗生素，直到可以進行骨活檢。 -治療的持續時間取決於所選擇的治療管理策略和目標。例如，脊椎骨髓炎的治療可能持續六週。
- 在開始靜脈注射抗生素或手術後 7 天后，如果患者情況良好，他們可能會改用口服抗生素（如果有良好的生物利用度和骨滲透）。
- 應考慮對以下任何一種情況進行手術：對藥物治療無反應的急性骨髓炎、慢性骨髓炎、化膿性脊椎骨髓炎並發症（例如神經系統損害、脊柱不穩、硬膜外膿腫）或感染的假體。