June 1985

Long-term Intravenous Antibiotic Therapy in Chronic Osteomyelitis

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine (Drs Wagner and Rytel), and the Section of Nuclear Medicine, Department of Radiology (Dr Collier), Medical College of Wisconsin, Milwaukee; and the Milwaukee County Medical Complex, Milwaukee (Drs Wagner, Collier, and Rytel).

Arch Intern Med. 1985;145(6):1073-1078. doi:10.1001/archinte.1985.00360060139022

• Because the optimal treatment of chronic osteomyelitis is not well established, we studied the efficacy of prolonged (three months or more) outpatient intravenous antibiotic therapy via a Hickman catheter. Seventeen patients were entered into our protocol (13 with chronic osteomyelitis, three with chronic septic arthritis, and one with subacute osteomyelitis). Pseudomonas aeruginosa was the most common bone isolate, followed by Staphylococcus aureus. Most patients had polymicrobial isolates. Patients were followed up with clinical examinations, serial measurements of erythrocyte sedimentation rate, and scans using technetium Tc 99m medronate and gallium citrate Ga 67. Of the ten patients with chronic osteomyelitis who completed therapy, eight were considered cured. After further follow-up, three of the cured patients had recurrences requiring additional therapy.

(Arch Intern Med 1985;145:1073-1078)