The Antibiotic Use in Osteomyelitis Infection: A Systematic Review

Introduction: Osteomyelitis is a serious infection of the bone. One of the therapies for osteomyelitis is antibiotic treatment. Antibiotic treatment has evolved substantially, but bone infections are still a challenge. Antimicrobial therapy is also difficult, caused by antibiotic-resistant organisms. Therefore, a systematic review is needed to assess antibiotic use in osteomyelitis infection. Method: Articles were searched using Pubmed with keywords “antibiotics”, “osteomyelitis”, and its combination. The authors used five years publication date and English language to select the appropriate journal. Result: The author identified 13 relevant articles with antibiotics use in osteomyelitis. All of the cases were about chronic osteomyelitis and osteomyelitis in diabetic foot ulcers. Osteomyelitis in other sites of long bones needs longer duration treatment than long bone osteomyelitis. In acute osteomyelitis in children, antibiotic treatment can switch from IV to oral antibiotics. Furthermore, chronic osteomyelitis needs longer treatment to resolve than acute osteomyelitis. Conclusion: Antibiotics still mainstay treatment with surgery for osteomyelitis treatment. With acute, children, and long bone only need shorter treatment than chronic, adult, and non-long bone osteomyelitis.

Treatment of acute osteomyelitis (Zentr. f. Ch., 1926, № 18)

Treatment of acute osteomyelitis was the programmatic theme of the XV Congress of Surgeons in Copenhagen on June 25-27, 1925 (Zentr. F. Ch., 1926, no. 18). Speakers on this issue, Johanson nSchilling, generally agreed that radical removal of the affected bone marrow is the treatment of choice for acute osteomyelitis.

Experimental Study On Antibacterial Properties of Iodine-Coated Implant in Acute Osteomyelitis Model

Purpose We have developed a iodine-coated implant and evaluated its antibacterial properties against Gram-negative bacteria by constructing an experimental osteomyelitis model.Methods In this study, 16 titanium Kirschner-wires were selected, of which 8 titanium K-wires were treated with iodine on the surface by electrophoretic deposition with PVP-I solution. In our study, the standard strain of Escherichia coli (ATCC 25922) was selected, and 16 New Zealand rabbits were selected. There were 8 rabbits in the iodine-coated group and 8 rabbits in the non-iodine-coated group. All animals were drilled in the left proximal tibia after successful anesthesia.After that,the iodine-coated group was implanted with iodine-coated titanium K-wires.Then, 25ul of 2×108CFU/ml bacterial suspension was injected into the bone marrow cavity with pipette gun, and the bone hole was sealed with bone wax.They were reared in cages for 1 week after operation, and evaluated and analyzed by microbiology, histopathology, scanning electron microscopy, etc.Results The results of gross wound score and microbiology showed that the wound infection of the iodine-coated group was less severe than that of the non-iodine-coated group, which was confirmed by the histopathological results. Scanning electron microscopy and confocal microscopy showed that the amount of bacteria on the surface of iodine-coated K-wires was significantly lower than that non-iodine-coated K-wires. Conclusions In this study, we have verified that the iodine-coated titanium implant could effectively inhibit E. coli infection in the early stage of infection by constructing an acute osteomyelitis model.

Aeromonas hydrophilia-infected nonunion of a closed tibial fracture in a healthy adolescent: A case report

Aeromonas hydrophilia can cause soft tissue infection in both immunocompromised and healthy persons. A healthy 15-year-old adolescent fell into a ditch after a scooter accident and sustained a right distal tibial shaft closed fracture, a right femoral shaft closed fracture, and a dirty laceration over the medial aspect of the distal thigh above the right knee. After empiric antibiotics and radical debridement of the contaminated wound, a femoral interlocking nail and tibial external fixator were applied. However, acute osteomyelitis later presented in his femur and tibia, and Aeromonas hydrophilia grew in cultures from the knee wound and the fracture sites. During the follow-up, his tibia became an infected nonunion, and was successfully treated with the induced membrane technique. In an otherwise healthy patient with a closed fracture, Aeromonas hydrophilia can cause acute osteomyelitis and necrotizing fasciitis by spreading from a nearby contaminated wound. Exposure to water is a risk factor for Aeromonas hydrophilia infection.