Term
| When is surgical drainage necessary? |
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Definition
| Presence of pus in aspiration, x-ray evidence of bone destruction, delay of presentation |
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Term
How long should duration of treatment last?
Minimum ?
Severe cases? |
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Definition
Treatment of osteomyelitis should last a minimum of 4 weeks.
6 weeks is required in severe cases.
10-14 days is sufficient in penetrating injury if debridement is performed. |
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Term
| Empiric treatment of Osteomyelitis in Neonates: Usual causative organisms? Empiric IV Abx |
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Definition
| Empiric treatment of Osteomyeletis in Neonates: Usual causative organisms - group B streptococci, gram(-) enterics, S.Aureus Empiric IV Abx: MRSA likely - Vanco + either cefotaxime or ceftriaxome MRSA UNlikely - cloxacillin + cefotaxime |
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Term
| Empiric treatment of Osteomyeletis in children: Usual causative organisms Empiric IV Abx |
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Definition
Empiric treatment of Osteomyeletis in children:
Usual causative organisms -
Staph A., Group A streptococci, H influenzae, S penumoniae
Empiric IV Abx:
MRSA unlikely - cloxacillin
MRSA possible - vancomycin
*If not immunized against H. influenzae also cefotaxime |
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Term
| Empiric treatment of Osteomyelitis in adults: Usual causative organisms Empiric IV Abx |
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Definition
Empiric treatment of Osteomyelitis in adults:
Usual causative organisms - S. Aureus, gram (-) enterics
Empiric IV Abx - Cloxacillin OR Cefazolin |
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Term
Osteomyelitis spread from head/neck:
Usual causative organisms
Empiric IV Abx |
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Definition
Osteomyelitis spread from head/neck:
Usual causative organisms: S.Aureus, anaerobes, gram (-)
Empiric IV Abx - clindamycin with or without gentamicin |
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Term
Osteomyelitis spread from soft-tissue:
Usual causative organisms
Empiric IV Abx |
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Definition
Osteomyelitis spread from soft-tissue:
Usual causative organisms: S. Aureus, streptococci
Empiric IV Abx - Cloxacillin or cefazolin |
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Term
Osteomyelitis spread from genitourinary:
Usual causative organisms
Empiric IV Abx |
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Definition
Osteomyelitis spread from genitourinary:
Usual causative organisms - gram(-) enteric bacilli
Empiric IV Abx - FQ or extended spectrum beta-lactam (3rd get cephalosporin, extended spectrum penicillin, carbapenem). |
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Term
Definitive treatment for Osteomyelitis
Pathogen: MSSA
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: MSSA
IV treatment: cloxacillin, cefazolin, clindamycin
Oral Continuation: Cloxacillin, clindamycin, cephalexin, amoxicillin-clavulanate |
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Term
Definitive treatment for Osteomyelitis
Pathogen: Strep A
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: Strep A
IV treatment: Penicillin
Oral Continuation:
Penicillin, Amoxicillin, Clindamycin |
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Term
Definitive treatment for Osteomyelitis
Pathogen: Strep B
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: Strep B
IV treatment: Penicillin
Oral Continuation: N/A |
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Term
Definitive treatment for Osteomyelitis
Pathogen: Enteric gram(-) bacilli
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: Enteric gram(-) bacilli
IV treatment: Cefotaxime
Oral Continuation: N/A |
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Term
Definitive treatment for Osteomyelitis
Pathogen: P. Aeruginosa
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: P. Aeruginosa
IV treatment: Ceftazidime + Gentamicin
Oral Continuation: Ciprofloxacin |
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Term
Definitive treatment for Osteomyelitis
Pathogen: MRSA
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: MRSA
IV treatment: Vancomycin
Oral Continuation: CA-MRSA may use clindamycin, if insensitive use home IV vancomycin |
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Term
Definitive treatment for Osteomyelitis
Pathogen: Mixed anaerobe/aerobe
IV treatment:
Oral Continuation: |
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Definition
Definitive treatment for Osteomyelitis
Pathogen: Mixed anaerobe/aerobe
IV treatment:
Carbapenem OR moxi OR piptazo OR amox/clav
Oral Continuation: Cipro + clindamycin or Amox/Clav |
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Term
Penetrating Trauma Osteomyelitis
Usual Causative organism:
Empiric treatment for adults
for children |
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Definition
Penetrating Trauma Osteomyelitis
Usual Causative organism: P.Aeruginosa, S.Aureus
Empiric treatment for adults:
FQ
For children:
cloxacillin + Ceftazidime + gentamicin |
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