Drugs for the treatment of osteomyelitis

Definition

Osteomyelitis refers to a complex and serious bacterial infection involving bones and bone marrow: the disease can have a chronic or acute course, and start at any time of life. Osteomyelitis is an infection that particularly affects the male, and is the most serious ever affecting the osteo-articular apparatus.

Causes

The infection is mainly sustained by streptococci and staphylococcal bacteria, although Escherichia coli, Klebsiella and Pseudomonas can also foment or cause damage.

• Risk factors: bacteremia, infectious foci, exposed fractures, surgery, deep trauma, tuberculosis, syphilis

Symptoms

Osteomyelitis begins with redness and swelling of the affected area, difficulty in moving the injured area, acute pain, fever and potential swelling. Possible formation of cutaneous fistulas with pus emission. In some cases, osteomyelitis occurs completely asymptomatically.

• Complications: bone shortening and skeletal deformities (in case of failure to treat)

Information on Osteomyelitis - Drugs for the Treatment of Osteomyelitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Osteomyelitis - Drugs for the treatment of Osteomyelitis.

drugs

Before listing the possible drugs useful for treating osteomyelitis, it is important to point out that immediate surgical intervention is essential for the prevention of the chronic form of the infection; moreover, before the rescue arrives, it is a good rule to wash the wound and medicate it, before covering it with sterilized gauze.

Being an infection supported by bacteria, osteomyelitis must be treated with broad-spectrum antibacterial drugs where the bacterium had not yet been isolated with precision; after that, the treatment should be continued with targeted antibiotics, active against that given pathogen.

Cephalosporins

• Cefazolin (eg Cefazolin GRP, Cefazil, Nefazol) belongs to the first generation cephalosporin class. Administer 1-2 g of drug every 6-8 hours; do not exceed 12 g per day. The duration of therapy is typically 4-6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require antibiotic therapy for 6 months.
• Cefuroxime (eg Cefoprim, Tilexim, Zoref, Zinnat) the drug in question is a second-generation cephalosporin, to be administered parenterally (intravenously) at a dose of 1.5 g every 8 hours. Approximately, continue the administration for 6 weeks. The chronic form of osteomyelitis may require an additional two months of therapy.
• Cefotaxima (eg. Cefotaxima, Aximad, Lirgosin): third-generation cephalosporin, generally administered intravenously or intramuscularly at a dose of 1 to 2 grams every 6-8 hours. Do not exceed 2 g every 4 hours. Therapy for acute osteomyelitis should be continued for 4-6 weeks; the chronic form also takes 6 months.

lincosamides

• Clindamycin (eg Dalacin-T, Clindamycin BIN, Zindaclin, Dalacin-C): the drug, derived from lincomycin, should generally be taken at a dosage of 450-900 mg IV, every 8 hours. When the patient has stabilized, oral administration of the drug is recommended, generally 450 mg every 6 hours. The duration of the therapy does not usually exceed 4-6 weeks, but the chronic forms require more dilated times (1-2 months).

Amoebiacs (nitroimidazoles)

• Metronidazole (eg. Flagyl, Metronid, Deflamon) is recommended to take the drug at a dose of 7.5 mg every 6 hours, intravenously. Continue therapy for 4-6 weeks (acute osteomyelitis) or 3-4 months (chronic form).

Quinolones

• Ofloxacin (eg. Exocin, Oflocin): belonging to the second-generation class of quinolones, oofloxacin is administered at a dose of 400 mg orally every 12 hours for 4-6 weeks (acute form) or 3-4 months (chronic form of osteomyelitis).
• Ciprofloxacin (eg. Ciprofloxac, Samper, Ciproxin, Kinox): for mild to medium forms of osteomyelitis, it is recommended to take the drug at a dose of 500 mg orally or 400 mg intravenously 2 times a day (every 12 hours) for 4-6 weeks. For the severe form, take 750 mg orally every 12 hours or 400 mg ev every 8 hours for 4-6 weeks.

glycopeptides

• Vancomycin (eg Zengac, Levovanox, Maxivanil): inject into a vein 15 mg / kg of drug (max. 1 gram) for slow infusion (1-2 hours) every 12 hours. The duration of the planned therapy is 3 months. Prolong drug treatment for an additional 1-2 months in case of chronic form of osteomyelitis.

penicillins

• Nafcillin (eg. Unipen) administer 2 grams of substance every 4 hours for 4-6 weeks, depending on the nature of the infection. When it comes to chronic osteomyelitis, prolong the treatment for another 6 months.

Analgesics : analgesic drugs are not essential for recovery from osteomyelitis but certainly represent a valid help for the patient, in order to overcome the disease more easily and with less pain. In this sense, analgesics are essential.

• Naproxen (eg Aleve, Naprorex): it is recommended to take one 550 mg capsule twice a day (every 12 hours, unless further medical indications), as needed.
• Ibuprofen (eg. Brufen, Kendo, Moment): take on the palate 200 to 400 mg of active ingredient (tablets, effervescent sachets) every 4-6 hours, as needed. In some cases, the analgesic can be administered intravenously (400 to 800 mg every 6 hours, as needed)
• Diclofenac (eg Pain Reliever, Flogofenac Retard, Momenlocaldol, Voltaren) is recommended to take the drug at 50 mg per os, every 8 hours. In case of acute pain, start with 100 mg of medication, then move on to 50 mg.
• Paracetamol or Acetaminophen (eg Tachipirina) indicated in case of fever in the context of osteomyelitis. The drug is available in the form of tablets, effervescent sachets and syrup. It is recommended to take paracetamol at a dosage of 325-650 mg every 4-6 hours for 6-8 consecutive days, to bring down the fever.

Note:

1. For diagnostic purposes, Scintinum (active ingredient: Besilesomab), a kit useful for preparing an injectable radioactive solution, is generally used to circumscribe and accurately identify sites of infection and inflammation with suspected osteomyelitis in the limbs.
2. In the event of chronic illness and impossibility of healing despite medications, surgery based on the excision of the infected material is the only viable option to avoid the dangerous complications of osteomyelitis.